Multiple Pregnancy

multiple-gestation

Pregnancy with more than one fetus is called multiple, and newborns are called twins.

In connection with the widespread use of ovulation stimulation drugs in the treatment of infertility and the development of IVF, there has recently been a tendency toward the increase of the number of women with multiple pregnancies.

The heredity, especially on the maternal line, is also important.

Twins can be dizygotic and monozygous.

Dyzygous – 2 eggs are fertilized by 2 spermatozoa. Such twins are always dichorial, diamniotic. That is, each of the fruits has its own amniotic and chorionic membrane.

Monozygous – 1 egg and 1 sperm cell are fertilized and division occurs: if such division occurs within 1-3 days after fertilization, then each fetus has its own amniotic and chorionic membrane.

If zygote division occurs on 4-8 days, they have one chorionic and two amniotic membranes. Monochorionic, diamniotic twins.

In such a situation, twin-twin transfusion syndrome may occur. That is, one fruit from twins will be a donor, the other – the recipient. The presence of one placenta predisposes to the fact that one of the fetuses will develop better (fetoplacental blood circulation, the amount of amniotic fluid and polycythemia), the second fetal donor will lag behind in development (worse fetoplacental circulation, less amniotic fluid and anemia).

If the zygote division occurs after 12 days of fertilization, the fruits will be fused together – “Siamese twins”

The course of pregnancy.

In women with multiple pregnancies, toxicosis of the first half of pregnancy is more pronounced than in singleton pregnancies. Higher concentrations of human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) are determined.

Appointed folic acid and iron preparations for the prevention and treatment of anemia.

Premature labor, premature rupture of amniotic fluid are a frequent complication of multiple pregnancy.

Births are conducted through the birth canal, if the first fetus is in the main presentation. If the second fetus is in a transverse position, then after the birth of the first child, it is possible to produce an external-internal rotation of the fetus and its extraction by the leg.

In the pelvic or transverse position of the first fetus, a cesarean section is recommended.