Twin Pregnancy – Double Trouble or Twice the Joy
News of a twin pregnancy is commonly associated with surprise and to some extent shock. However; if managed well, twins can definitely bring twice the joy. Also, twin pregnancy is on the rise due to assisted reproduction techniques. The most important factor in twin pregnancy management and outcomes is whether the babies each have a separate placenta (Dichorionic) or share a single placenta (monochorionic). This crucial detail can be made out in the very first trimester at the time of the NT scan.
Dichorionic pregnancies have lesser complications compared to monochorionic as the latter face some very specific challenges due to unequal sharing of blood flow from the common placenta. However; these will be seen only in 15% of monochorionic twins. Fortunately, the remaining 85% will do as well as their dichorionic counterparts.
Generally twin pregnancies will need closer supervision with more sonographies throughout pregnancy. Another very important risk in twin pregnancy is increased chances of preterm delivery. Again, not all twins experience this. However; many will need medicines to prevent the same. A few might need a surgery (cerclage) to prevent the cervix from opening prematurely.
Mothers can experience higher incidence of diabetes or hypertension in twins. Therefore, it is very important that mothers remain cautious and follow medical advice at all times. It is very common for twins to be delivered around 36-37 weeks. Caesarean delivery is overwhelmingly more common as twins might not meet all the criteria for vaginal delivery (most commonly both babies not being “head down”) and simultaneously have some other high-risk factor.
Overall twin pregnancy can be very gratifying and indeed unique experience.
Dr. Ashwini Rathi is Director of Mumbai Fetal Medicine Centre, Irla Parimal society, Off Juhu lane. Andheri (W) and a consultant at Surya Mother and Child hospital, Santacruz.
For appointments please call – +91-8669227227.