How is a multiple pregnancy managed before birth?
Women who are carrying two or more babies are monitored by their doctor more frequently during pregnancy because of an increased risk of complications.
One of the most significant risks for the babies is an early (premature) birth. Six in 10 twins and almost all higher-order multiples are born prematurely (before 37 weeks of gestation). Babies born prematurely are at greater risk than full-term babies of having long-term health problems and may also require hospital care. If the babies are monochorionic (sharing the same placenta), they are also at increased risk of sharing abnormalities like twin-to-twin transfusion syndrome (TTTS), a potentially life-threatening condition in which blood flows unevenly between the babies while they are in the womb. A multiple pregnancy also raises health risks for the mother, including anemia (low levels of red blood cells), preeclampsia (a high blood pressure disorder), gestational diabetes (high blood sugar levels), and postpartum hemorrhage (abnormal blood loss after giving birth). Your pregnancy care will be determined by the type of multiple pregnancy you have (dichorionic-diamniotic, monochorionic-diamniotic, or monochorionic-monoamniotic), the number of babies you are carrying, your overall health, your medical history, and your expectations for your pregnancy and delivery. This care will include more frequent prenatal visits and, starting in the second trimester, more frequent ultrasounds—every two to four weeks, depending on the type of multiple pregnancy. You will also be referred to a maternal-fetal specialist, who may recommend special testing and who will coordinate your medical care for possible complications. In addition, you’ll receive special nutritional counseling. Women who are carrying more than one baby need extra calories, protein, and other nutrients. If TTTS has been diagnosed, a prenatal laser surgery procedure may be recommended to ensure a healthy flow of blood to both of the babies.
How is a multiple pregnancy treated after birth?
Our goal will be to have your babies delivered as close to your due date as possible. Because the placenta in twin pregnancies is under added stress, dichorionic twins are usually delivered by 38 weeks gestation and monochorionic twins by 37 weeks gestation. With twins, a vaginal delivery may be feasible, depending on the position, weight, and health of your babies. Triplets and other higher-order multiples are usually born by cesarean section. Because twins and higher-order babies are more likely to be born prematurely and require special care after birth, we may recommend that your babies be delivered at one of our specialized mother-baby centers. Children’s Minnesota is one of only a few centers nationwide with the birth center located within the hospital complex. This means that your babies will be born just a few feet down the hall from our newborn intensive care unit (NICU). If necessary, many of the physicians you have already met may be present during or immediately after your babies’ birth so we can care for them right away.
What is the long-term prognosis for my babies?
The long-term prognosis for twins and higher-order multiples is excellent, but it is heavily dependent on the babies’ gestational age at birth.
Will my babies need long-term follow-up care?
Your babies will not need any long-term follow-up care, although such care may be required for other conditions associated with premature birth.
Need a referral or more information? You or your provider can reach the Midwest Fetal Care Center at 855-693-3815.