Multiplicity: Gemini and more

Multiple fertility means that there are two or more fruits in the uterus. Children can be monotonous or develop from different ova. Children who develop from one egg, called odnoyaytsevymi. This happens when one egg is fertilized by one sperm, and then divided into two or more embryos. Experts link the cause of the division of the egg into several parts with age, race or family predisposition.

Identical twins:

• Children of the same sex
• Have one blood group
• Perhaps they will have the same body constitution, skin color, hair and eyes, but that does not mean they will always look the same. In addition, fingerprints will also be different.

Children who develop from different oocytes are called fraternal or non-identical. This happens when two eggs are impregnated with different spermatozoa. Nonidentical twins are born in families where this has already happened before. Nonidentical twins can:

• be of different sexes
• have a different blood type
• be similar or different from each other

What provokes multiple pregnancies?

Multiple fertility often occurs with artificial insemination or when taking medications that provoke fertility. When taking drugs from infertility, the body of a woman can produce several eggs, so the chance of fertilization of several eggs increases.

With artificial insemination, several eggs with spermatozoa are mixed in the laboratory. After fertilization, several eggs are placed again in the uterus to increase the chances of a woman to have a baby.

The possibility of having several children at the same time increases:

• at the age of 35 or older
• if you have African roots
• if you previously had twins
• with family predisposition
• when the woman just stopped taking the contraceptive

Multiple Fetus: Risk Factors

At any pregnancy there is a certain degree of risk, but it increases in multiple pregnancies. In case of multiple pregnancies, the risk is increased:

• development of pre-eclampsia
• development of gestational diabetes
• premature birth (if the baby is premature, the organs can not yet be fully formed, which affects the condition of the lungs, brain, heart and vision);
• a miscarriage (a woman may lose one or more children).

The genetic factor also plays an important role, as the anomaly of genes provokes the development of birth defects. It is necessary to consult a doctor if someone from your family has children with genetic diseases. There are certain tests that allow you to identify genetic disorders or defects for 10-20 weeks of pregnancy. Remember that it may not touch you. Every day healthy twins are born.

How will multi-fertility determine?

To say with certainty that you have multiple pregnancies, only a doctor with ultrasound can. The monitor shows the number of fruits and their condition. In case of multiple pregnancies, ultrasound is diagnosed more often in order to determine possible signs of impaired fetal development and how they grow.

Treatment for multiple pregnancies

When multiple births, you should visit a doctor a little more often than usual because of the risk of developing pathologies. During each visit, the physician conducts a physical examination, measures blood pressure, appoints a blood and urine test, and recommends the use of ultrasound. Try not to miss these planned visits, because in case of problems you need to start treatment on time.

You have multiple pregnancies. What's next?

Perhaps the very idea of the birth of several children is alarming, but do not be afraid. Use simple tips on how to preserve your health and the health of future children.

Most importantly, take care of yourself. The better your health, the healthier your children will be. During pregnancy, you should:

• visit a doctor regularly
• adhere to a healthy diet and diet: eat high-calorie foods with a high content of folic acid, iron and calcium (they are necessary for the healthy development of the child); bread, cereals, meat, milk, cheeses, fruits and vegetables are best suited; if you are constantly harassed by nausea and vomiting and you can not eat normally, consult a doctor;
• do not smoke
• do not drink alcohol and drugs
• Do not drink coffee
• Do not take drugs, vitamins or herbs without first consulting your doctor
• discuss with your doctor suitable activities (exercise) that will work during pregnancy
• have a lot of rest

After giving birth, you, for sure, will feel excessive fatigue, and you will think that you can not cope with all the duties. Do not worry, this is quite normal. Most young mothers think the same way.

To relieve tension, use the following guidelines:

• Ask family members or friends to help you
• as often as possible rest
• Visit the support groups for young mothers who have had twins; there you can get answers to all questions of interest
• In case of depression, which occurs more than 2 weeks, consult a doctor.

Reduction in the number of developing fetuses in multiple pregnancies

When artificial insemination with a doctor should be discussed how many embryos to transfer to the fallopian tube. The number of developing fetuses affects the course of pregnancy and the condition of children at birth. If multi-fertility is diagnosed, you may be asked to consider reducing the developing fetuses in order to increase the chances of survival of one fetus.

Successful artificial insemination and the risk of multiple pregnancies

Women over 35 need to transplant more embryos than those younger. The more embryos, the higher the chances of pregnancy and the birth of a child. But along with this, the risk of multiple pregnancies also increases. Women over 40 are at risk for loss of embryos when their own eggs are fertilized. In this case, as an alternative, donated eggs are used. If you are thinking about artificial insemination and taking drugs to increase fertility, you should consult with your doctor about how to avoid multiple births, because the decision to reduce developing fruits is not easy and painful. Multiple fetuses are considered complications as a result of artificial insemination, as the risk to both the mother and the fetuses increases (preeclampsia, miscarriages, premature birth and a number of health problems for children). The more developed in the uterus of the fetus, the higher the risk of complications during labor.

Reduction of developing fetuses in multiple pregnancies is a procedure that is performed in the first trimester of pregnancy in order to reduce the number of fetuses when three, four or more fetuses develop in the uterus. Usually leave two. The purpose of this procedure is to increase the chances of a healthy pregnancy and the birth of full-term children. If you are thinking about reducing developing fetuses during pregnancy, take into account the following:

• With every additional fetus in the uterus, the risk of illness, death or disability increases.
• Successful reduction of fetuses lowers the risk and is aimed at the healthy course of pregnancy and the birth of a full-term baby.
• The procedure for reduction of fetuses can lead to miscarriage of other fruits: more than 6 out of 100 cases of triplets result in miscarriage, while 19 out of 100 premature babies die in the first year of life in such cases.
• Early diagnosis (biopsy of chorionic villi and ultrasound) is aimed at identifying birth defects of the fetus. This information will help to decide on the reduction of fetuses in multiple pregnancies.

Medical information

What is the reduction of fruit in multiple pregnancies?

This is a procedure during which the number of developing fruits decreases (three, four or more), leaving two and increasing their chances of survival.

This procedure is carried out in the first trimester between 9-12 weeks of gestation, sometimes after genetic diagnosis for signs of birth defects. The most common method of reducing fetuses is the transabdominal, during which the doctor uses ultrasound monitoring to select the fetus and stops his heartbeat. Sometimes there is vaginal bleeding, which is considered the norm. The dead embryo is absorbed by the mother's body. This process is similar to the spontaneous reduction of one or more fetuses in multiple pregnancies, known as the "vanishing twin syndrome".

The advantages of reducing fetuses in multiple pregnancies

Family life. At the expiration of two years after the birth, the parents of the twins reported that there was less concern in their lives than the parents of the triplets.

Risk to the health of the mother. Multiple fetuses (three or more fetuses) increase the risk of complications, for example, gestational diabetes, preeclampsia or anemia, with the risk increasing with each additional fetus.

Risk of fetal health. With multiple births, the risk of miscarriage, stillbirth, premature birth and disability increases. Only half of the families who have a triplets have healthy children. One third of parents who have four children at the same time, bring up healthy children. To reduce the risk, many doctors recommend fetal reduction in multiple pregnancies, as the procedure prevents miscarriage and increases the chances of a full-term and healthy child.

Multiplicity: Symptoms

In case of multiple pregnancy, the woman has the same symptoms as with usual pregnancy, but they can manifest much earlier and may develop with complications. In the case of multiple pregnancies, one observes:

• early and severe form of first-trimester toxicity
• excessive weight gain
• back pain
• large size of the uterus for gestational age
• increased fetal activity in the second trimester and later

Later observed:

• Phlebeurysm
• Constipation
• Hemorrhoids
• Difficulty breathing (which is caused by excessive pressure on the lungs)
• Increased pain in the lower back
• Digestive disorder (as a result of the pressure of the uterus on the stomach)
• Gestational diabetes
• Large belly size
• Pre-eclampsia (impaired blood circulation and pressure, which affects the health of the mother and fetus)
• Premature birth

Multiple Fetus: Diagnosis and Testing

Previously, women did not even imagine that they were carrying twins, triplets or more children until their very birth. With the development of ultrasound diagnostics and modern testing, one can learn about multiple pregnancies already in the first or second trimester of pregnancy. Ultrasound can practically accurately show the presence of several fruits in the uterus. After confirming the multiple birth, you will need to undergo ultrasound diagnosis several times during pregnancy so that the doctor can monitor the growth of the fetus and amniotic fluid. Sometimes they learn about multiple pregnancies after taking tests, which were carried out for a different purpose. For example, a high level of human chorionic gonadotropin testifies to the bearing of several fruits by a woman.

Tests for genetic diseases and birth defects. Fetuses during multiple pregnancy are at risk due to genetic diseases and birth defects.

Testing:

• Chorionic villus biopsy. Through the vagina, a catheter is inserted into the placenta and a small piece of the placenta is aspirated. Such a procedure is usually conducted between 10 and 12 weeks of pregnancy.
• Amniocentesis-aspiration of the fluid (amniotic fluid), in which the embryo is located in the uterus, by piercing the amniotic sac through the abdominal wall. It is conducted between 15 and 20 weeks of pregnancy, and in some cases - at the end of the third trimester of pregnancy to determine the state of the lungs of a child immediately before childbirth.
• Chorionic villus sampling and amniocentesis slightly increase the risk of miscarriage Chorionic villus sampling and amniocentesis have an insignificant risk of miscarriage in the testing of multiple fetuses. Diagnosis of fetuses and mothers in multiple pregnancies:
• The measurement of blood pressure is carried out at each visit of the doctor for signs of pre-eclampsia.
• A blood test for a sign of anemia (low iron level in the blood). This problem is very often observed in multiple pregnancies, because the fruits use a large amount of iron from the mother's body.
• Urinalysis for urinary tract infection.
• Transvaginal ultrasound examination for determining the length of the cervix. Its short size indicates an increased risk of premature birth.
• In the second trimester, an oral glucose tolerance test is performed for signs of gestational diabetes.
• Electronic monitoring of the fetal heart rate can be performed before and during labor to determine the state of health of the unborn child.

Multiple Fertility: Treatment Overview

Always monitor your health during pregnancy. If you are pregnant with twins or more (with multiple births), try to follow a balanced nutritional diet. Make sure you get enough calcium, iron and folic acid.

Perhaps you will gain more weight than a normal pregnancy with one fetus. Each additional fruit adds extra pounds. The amount of kilos gained during pregnancy depends on whether the weight before conception was insufficient or superfluous.

Care for a pregnant woman who is at risk

• In case of multiple pregnancy, a pregnant woman needs good care. This will help to avoid complications, but you will need to visit a doctor more often than usual.
• At any period of pregnancy with multiple pregnancies, complications may develop. These include:
• Miscarriage, premature birth, preeclampsia, gestational diabetes and serious impairment of the placenta.
• Spontaneous reduction of one or more fetuses in multiplicity, known as "vanishing twin syndrome", the development of birth defects and genetic disorders.
• Visual impairment, lung and heart function in a preterm neonate.
• Mental retardation of the child, cerebral palsy, learning problems, blindness or deafness (most often develop in children born before 28 weeks).
• The risk of preterm labor in multiplicity increases, so plan everything in advance. Find a doctor and choose a hospital where, if necessary, you will have a cesarean section and there is resuscitation.

Multiple Fetus: Complications

When three or more fetuses develop in the uterus, the risk of birth defects or disorders increases with each additional fetus. If you have triple or more as a result of taking medications that promote fertility, the doctor can recommend reduction of the fruit at the end of the first trimester. Successful reduction in the number of fetuses increases the chances of having healthy children, but in very rare cases is the cause of miscarriage.

The decision to reduce the number of fruits is not easy and causes injury to parents. If you are confronted with this problem, talk with your doctor about the risk of bearing all the fruits compared to the risk of reduction. Be sure to consult with a psychologist or spiritual mentor. Premature births are most common in multiple pregnancies, rather than with normal pregnancy. If the birth activity begins, the doctor can recommend the following:

• Limit physical activity.
• To lie on in-patient observation, to take steroid preparations for the early maturation of the lungs. In some cases, tocolytic medicines are used (which reduce labor activity), but they have side effects, namely, pulmonary edema in multiple pregnancies.

There is no evidence that bed rest and supervision at home slows down the labor activity. Discuss with the doctor the possibility of partial bed rest and reduced activity at home.

Complications of multiple pregnancy:

• Preeclampsia and high blood pressure. Treatment depends on the severity of the form of the disease and overall health and may include taking medications, bed rest, monitoring the fetus, and premature birth.
• Disruption of the placenta: premature detachment of the placenta, placenta previa.
• Anemia, in which drugs containing iron are prescribed. If there is no positive result, additional testing is conducted to identify the causes.
• A large amount of amniotic fluid of the bladder (polyhydramniosis). Treatment involves taking drugs and pumping out excess fluid.
• Inflammatory process of the urinary tract, at which antibiotics are prescribed.
• Great loss of blood after delivery, requiring blood transfusion.
• Necessity of carrying out cesarean section in case of wrong arrangement of fruits (breech presentation).
• Such complications can occur with any pregnancy, but multiple pregnancy significantly increases the risk of their development.

Newborn: Complications

Possible complications include severe childbirth, healthy development of one twin and a lag in the development of another, as well as birth defects.

Complications that can occur in a baby with multiple pregnancies

• Premature birth is often observed in multiple pregnancies. Premature babies generally need to be resuscitated until their health status stabilizes.
• If the child is born prematurely, its organs are not yet fully formed, which can lead to the development of various diseases, especially children who are born before 32 weeks are exposed, with the risk increasing with each week of prematurity.
• As a result of premature birth, there is a possibility of disability, which implies special care for children.

Multiple Fetus: Home Treatment

In case of multiple pregnancy, a severe form of morning toxemia can be observed in the first trimester of pregnancy, but a woman is hospitalized in case of dehydration and severe vomiting when she can not eat and drink.

Signs of premature birth include:

• cramping pain similar to menstrual pain;
• pain in the abdominal cavity, possibly accompanied by diarrhea;
• uterine contractions that do not go on for a long time (4 times in 20 minutes or 8 per hour);
• a feeling of pressure in the lower back, especially if it appears from time to time.
• increased vaginal discharge.

Immediately seek medical help if symptoms of premature birth occur.

Go immediately to the hospital when there is vaginal bleeding or rupture of the bladder.

General recommendations for multiple pregnancies

• Balanced eat: eat high-calorie food, take folic acid and calcium for the full development of the fruit.
• Do not smoke, do not drink alcohol, caffeine, medications without consulting a doctor, chemicals, do not X-ray, avoid the use of certain cosmetics, do not overheat (this is usually recommended for any pregnancy)
• Reduce the level of physical activity. Most doctors recommend stopping sports after 24 weeks of pregnancy. Consult with your doctor about walking in the fresh air and swimming.
• Have a lot of rest, especially after 24 weeks of pregnancy. As studies show, adherence to strict bed restraint does not prevent premature birth.
• Think about changing the usual work schedule, especially if you are not feeling well. Sometimes a doctor recommends reducing activity to a minimum.
• Visit your doctor regularly. From 20 weeks you will have to see your doctor every two weeks, and after 30 - even more often.

When children are born

Carrying out several twins, and then caring for them at the same time - is a very difficult task, so mothers feel depressed and exhausted. Lack of sleep, increased workload, lack of personal time and difficulties in housekeeping accompany parents who have had twins. When it is necessary to care for newborns, most parents feel guilty, as it is not possible to easily cope with duties, as it was before. It's quite normal. Ask relatives or friends to help you. They can cook food, go to the store, do housework and look after children when you need to rest. Rest at any opportunity during the day.

The feeling of sadness and depression (postpartum depression) is often observed at the birth of twins. If this condition lasts more than two weeks or you have restless thoughts, consult a psychologist. It is important to start treatment in time.

Visit support groups for parents who have had twins. Sharing experiences with other parents will help cope with temporary difficulties.

Lactation. Breastfeeding several children at the same time is difficult, but it helps to establish close ties with each of them, and also helps to strengthen their health. If you plan to breastfeed the twins, get all the necessary information from a lactation specialist or the hospital.

Education. Children will develop in different ways, so you need to help them form their own identity. Take time for each child, stay alone and talk about exciting issues. If the family has older children, you need not forget about them, so think about when it is best to meet and with them alone.

Loss and sorrow

Multiple fetuses increase the risk of fetal death. In spite of when it happens - at the early stage of pregnancy or after childbirth - give yourself time to burn and realize the bitterness of loss.