Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0044/00442.txt

Text File | 1993-06-22 | 8KB | 136 lines

$Unique_ID{PAR00442}
$Pretitle{}
$Title{Pregnancy:  The Third Trimester:  Special Situations}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{Third Trimester Special Situations multiple births Twins triplets
quadruplets older pregnancy pregnancies fertility drugs identical fraternal
ultrasound Two babies amniotic sacs placentas abdomen stretching sooner aches
earlier Backache leg pain pains Stretch marks Fatigue placentas Complication
Complications premature delivery preemies Anemia iron deficiency preeclampsia}
$Log{
Fraternal and Identical Twins (Caption)*0044201.tif
Fraternal Twins (Image)*0044201a.tif
Identical Twins (Image)*0044201b.tif}

Miracle of Birth


The Third Trimester:  Special Situations

Carrying More Than One Baby


     We all share a common fascination with multiple births.  Twins, triplets,
and quadruplets excite the curiosity of family, friends, and the news media
alike.  As their due date draws near, many women groan that they must be
carrying more than one baby.  In some cases, they are right.

Incidence

     Twins are actually relatively common; they occur once in about every 88
deliveries.  Triplets (three babies) occur once in about 7700 deliveries;
quadruplets (four babies), once in about 680,000 deliveries; and quintuplets
(five babies), once in several million deliveries.
     There are a number of factors that may increase your likelihood of having
a multiple birth.  The older you are when you become pregnant, the more likely
you are to have a multiple birth.  Also, the more pregnancies you have had,
the more likely you are to carry more than one baby.  Your family history is
also important.  If a woman has twins in her family, she is more likely to
have a multiple birth.  The use of certain fertility drugs, which can cause
the production of two or more eggs at a time, may also lead to a multiple
birth.  Of course, some women who have none of these predisposing factors
experience multiple births.

Types of Multiple Birth

     Babies from a multiple birth are either identical or fraternal.
Identical twins, for example, are exact duplicates of each other.  They are
always the same sex--either two boys or two girls.  Identical twins result
when a single egg divides into two similar structures shortly after
fertilization.  Each of these resulting cells grows to become a separate but
identical baby.  About one third of all twins are identical.
     Fraternal twins, on the other hand, develop from two different fertilized
eggs and may or may not be the same sex.  Even though fraternal twins share
certain family traits and characteristics, they will not be identical in
appearance.  About two thirds of all twins are fraternal.
     Higher numbers of babies--triplets or quadruplets, for example--may be
identical, fraternal, or a combination of the two.  In the case of triplets,
for example, two babies may be identical and one fraternal.  With quadruplets,
two babies may be identical and two fraternal.

How Will I Know if I'm Carrying More Than One?

     During your pregnancy, your doctor may suspect that you are carrying more
than one baby based on several observations.  First, your doctor may notice
that your uterus is growing quite rapidly, more so than he would expect for
one baby.  If, for example, your uterus is twice as large as it should
normally be during your fourth month, your doctor may suspect twins.  Another
tip-off that you may be carrying twins is that you gain weight rapidly after
the fifth month of pregnancy.  Also, during your monthly office visits, your
doctor may be able to feel two distinct heads or hear two heartbeats; each is
a sure sign that you are carrying more than one baby.
     An ultrasound test (see The Fourth Month:  Ask the Doctor) can also be
used to diagnose the presence of more than one baby.  This safe procedure uses
sound waves to create a picture of the baby--or babies--within your uterus.
If your doctor sees two separate babies, then you are definitely going to have
twins.  Before the widespread availability of ultrasound tests, X rays were
used to detect the presence of more than one baby.  Today, however, the
potential side effects of X rays make ultrasound the test of choice for
determining if you are carrying more than one baby.
     Early diagnosis is important in order to provide you and your babies with
appropriate prenatal care.  If you are carrying more than one baby, your
doctor will need to conduct further tests and will need to see you much more
frequently.

What to Expect if You are Carrying More Than One Baby

     As you might imagine, being pregnant with two or more babies differs from
being pregnant with just one.  Two babies and two amniotic sacs (and, in some
cases, two placentas) mean twice as much weight to carry and twice as much
stretching of your abdomen.  Therefore, many of the usual aches and pains of
pregnancy will occur sooner and may be more extreme.  Backache and leg pain
will occur earlier and will probably be more intense because your uterus will
expand more rapidly and will grow larger than it would if you were carrying
only one baby.  Stretch marks on the skin of the abdomen will also appear
sooner and may be larger.  Fatigue may also be more intense.  Since two
placentas may now be producing hormones, morning sickness may be more intense
and may last beyond the first trimester.  With more than two babies, these
aches and pains are accentuated even more.

Complications

     Unfortunately, carrying more than one baby is also associated with a
slightly higher risk of certain complications.  The most serious complication
is the premature delivery of the babies--that is, delivery well before your
estimated due date.  It is not entirely understood why nearly two thirds of
all women who are carrying twins go into labor before the ninth month.  Labor
may occur even earlier with three or more babies.  Some authorities believe
that the mother's body may be fooled into thinking it is time to go into
labor.  Once the uterus reaches a certain size--whether it contains one, two,
or three babies--it may begin to contract, and labor may start.
     The problem with premature babies ("preemies") is that their organs,
especially the lungs, may not be developed enough for them to live outside the
mother's body.  These premature babies generally require expert medical care
in intensive-care nurseries.
     The woman who is carrying more than one baby is also more likely to
develop certain complications.  Anemia--an abnormally low blood count--is one
common complication.  In pregnancy, the developing baby normally takes iron
from the mother's body to make blood cells and tissue, so the mother may
become iron deficient and develop a low blood count.  Two or more developing
babies take more iron and therefore increase the mother's likelihood of
developing anemia.
     Another common complication in the woman who is carrying more than one
baby is preeclampsia, a condition marked by extremely high blood pressure (see
The Second Trimester:  Special Situations).
     If you are pregnant with more than one baby, your doctor will examine you
more frequently and will give you specific instructions about nutrition and
physical activity.  In general, you will be advised to stop working and reduce
your physical activity after your thirtieth week of pregnancy.  Your doctor
will probably also increase your iron supplement to prevent anemia.  With
early diagnosis and good prenatal care, most of the increased risk associated
with carrying more than one baby can be reduced or eliminated.