Twins
and more - Multiple Pregnancy
Complications
Multiple pregnancies are at greater risk of;
1. Chromosomal abnormalities (see
Prenatal diagnosis). Dizygotic
twins are more common in older women, who have a greater risk of chromosomal
problems, and each egg carries its own risk. Special counselling is
advisable regarding this issue in multiple pregnancy.
2. Fetal abnormalities. The risk
for the non-identical (dizygotic) twins is the same as a singleton,
but identical twins have a four-fold increase in the risk of finding
an abnormality.
3. Common obstetric problems. There
is an increased risk of developing antepartum and postpartum haemorrhage
(see Haemorrhage), hypertension www.pregnancycare.co.uk/hypertension
diabetes, anaemia and deep venous thromboembolism (see Major
symptoms) among other problems in twin pregnancy.
4. Death of one twin can affect the chances
of the remaining twin staying alive or being handicapped
5. Twin-twin transfusion syndrome. This
can happen if the twins share the same sac and placenta. One fetus gets
too much blood, becomes big and has extra fluid around it (polyhydramnios),
while the other receives too little, is small and has no fluid around
it (oligohydramnios - stuck twin). If the extra fluid around the recipient
(big twin) becomes too much for the uterus the woman presents with a
rapidly swelling, painful abdomen. She may require drainage of the fluid
or laser to the vessels communicating from one side of the placenta
to the other.