Multiple Pregnancy

A multiple pregnancy is when a woman is pregnant with two or more fetuses. Multiple pregnancies occur in about 3% of all births. The more babies in a pregnancy, the greater the risks of problems to the babies and mother. This includes death. Since the use of Assisted Reproductive Technology (ART) and medications that can induce ovulation, multiple fetal gestation has increased.

RISKS TO THE MOTHER

  • Preeclampsia and eclampsia.

  • Postpartum bleeding (hemorrhage).

  • Kidney infection (pyelonephritis).

  • Develop anemia.

  • Develop diabetes.

  • Liver complications.

  • A blood clot blocks the artery, or branch of the artery leading to the lungs (pulmonary embolism).

  • Blood clots in the leg.

  • Placental separation.

  • Higher rate of Cesarean Section deliveries.

  • Women over 35 years old have a higher rate of Downs Syndrome babies.

RISKS TO THE BABY

  • Preterm labor with a premature baby.

  • Very low birth weight babies that are less than 3 pounds, especially with triplets or mores.

  • Premature rupture of the membranes.

  • Twin to twin blood transfusion with one baby anemic and the other baby with too much blood in its system. There may also be heart failure.

  • With triplets or more, one of the babies is at high risk for cerebral palsy or other neurologic problem.

  • There is a higher incidence of fetal death.

CARE OF MOTHERS WITH MULTIPLE FETAL GESTATION

Multiple pregnancies need more care and special prenatal care.

  • You will see your caregiver more often.

  • You will have more tests including ultrasounds, nonstress tests and blood tests.

  • You will have special tests done called amniocentesis and a biophysical profile.

  • You may be hospitalized more often during the pregnancy.

  • You will be encouraged to eat a balanced and healthy diet with vitamin and mineral supplements as directed.

  • You will be asked to get more rest and sleep to keep up your energy.

  • You will be asked to restrict your daily activities, exercise, work, household chores and sexual activity.

  • If you have preterm labor with small babies, you will be given a steroid injection to help the babies lungs mature and do better when born.

  • The delivery may have to be by Cesarean delivery, especially if there are triplets or more.

  • The delivery should be in a hospital with an intensive care nursery and Neonatologists (pediatrician for high risk babies) to care for the newborn babies.

HOME CARE INSTRUCTIONS

  • Follow the caregiver's recommendations regarding office visits, tests for you and the babies, diet, rest and medications.

  • Avoid a large amount of physical activity.

  • Arrange to have help after the babies are born and when you go home from the hospital.

  • Take classes on how to care for multiple babies before you deliver them.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a temperature of 102° F (38.9° C) or higher.

  • You are leaking fluid from the vagina.

  • You develop vaginal bleeding.

  • You develop uterine contractions.

  • You develop a severe headache, severe upper abdominal pain, visual problems or excessive swelling of your face, hands and feet.

  • You develop severe back pain or leg pain.

  • You develop severe tiredness.

  • You develop chest pain.

  • You have shortness of breath, fall down or pass out.