Multiple pregnancy: signs, in the early stages by week, causes, complications. Will you have twins: how to determine without ultrasound? How to find out about multiple pregnancy before ultrasound

If either twins or twins were born in a family on the maternal side, then expectant mothers quite often think about whether they will have the same double happiness. Indeed, in this case, there is a huge probability of multiple pregnancy, which will need to be taken quite seriously.

Twins occur when several eggs are fertilized at the same time. Such a pregnancy can be determined by the first planned ultrasound procedure. But many people think about the question of how to find out if it’s twins or not without an ultrasound?

It is worth noting that there are several ways in which you can understand how to identify twins without an ultrasound. But you need to remember that they are not one hundred percent reliable, like an ultrasound examination. But many women still use them:

Taking a blood test for hCG. This is a special glycoprotein hormone that confirms the presence of pregnancy on ultrasound. If a girl has a multiple pregnancy, the levels of this hormone increase several times, so you can understand that there will be twins. If the doctor has impressive work experience, he will immediately determine, by looking at these test results, that there are twins in the pregnant woman’s tummy. How do expectant mothers feel when they hear this news? It varies, but in most cases the first reaction is slightly panicky, since it is a complete surprise, but very pleasant, so many cannot immediately realize it.

Conducting a special AFP test, which is carried out in the second or third trimester. This test is very important, because if there are twins in the stomach, a positive result will immediately appear without any kind of abnormalities.

Quite often, medical institutions resort to the following method: the doctor listens to the fetal heart sounds. After all, it is known that the baby’s heart begins its formation from 5-6 weeks after conception, but you can listen to the heartbeat only when the second trimester of pregnancy begins. During this method, the doctor listens to heart sounds in several areas of the uterus. But scientists have discovered that between the two fetuses there is a place where the tones cannot be heard, and so the frequency is different, this moment also makes the doctor understand that the pregnant woman will have twins.

At the appointment, the doctor also palpates the woman’s abdomen, feeling large parts of the baby’s body. But this method does not accurately determine whether the pregnancy is multiple.

During an early gynecological examination, the doctor may notice that the uterus has increased quite significantly in size. This fact also indicates the presence of twins.

Many expectant mothers are interested in how long it takes to identify twins? It is worth noting that already at 5-6 weeks it can be determined that such good news awaits the mother.

A sign of twins can be this: the mammary glands rapidly increase in volume, and when touching them, the woman feels incredible pain. It is worth noting that during normal pregnancy, breasts also increase in volume, but not so much.

There are other methods, folk methods that have come to us since the times of our great-grandfathers. Of course, sometimes they are inaccurate, but most of the time they are not very true.

When a woman carries twins under her heart, her body is subjected to double the load, so her organs work several times faster, in an enhanced mode. Therefore, the pregnant woman’s well-being immediately deteriorates:

First of all, severe toxicosis appears, and in the very early stages. It is caused by a large number of toxins, which is why increased nausea and vomiting occur. It’s hard for a woman to bear it, her mood leaves much to be desired. But this method is not always reliable, since toxicosis can overtake a woman even during a singleton pregnancy.

When a woman has twins, her appetite immediately increases, in addition, she constantly feels that she wants to eat. Excessive fatigue and frequent urination also plague the pregnant woman constantly. When the second or third trimester begins, many people experience severe swelling in their legs and shortness of breath. Women especially gain a lot of weight; their belly looks simply huge.

Since there are a lot of hormones during multiple pregnancy, anemia begins to develop. But this is also not an accurate method, since anemia can also develop in pregnant women with one child.

The presence of twins in the stomach is confirmed by bright and clear stripes on the test. They say that the woman has a highly elevated level of HcG in the blood.

Be that as it may, it is advisable to check the reliability of the above methods using an ultrasound procedure. After all, it will not only confirm the presence of a multiple pregnancy, but will also indicate other important parameters in the development of the fetus. The doctor will tell you if there are any problems or abnormalities in the pregnancy, whether the babies are in the right position, and so on.

Under no circumstances should you refuse an ultrasound scan, because a multiple pregnancy is a risky pregnancy, so doctors often prescribe this procedure in order to constantly monitor the fetuses.

In order for a pregnant woman with twins to always be under the control of experienced specialists, after 30 weeks she is offered to go into confinement. Also, in many cases, birth is premature and is in danger of being interrupted.

But how a multiple pregnancy will proceed will depend on the characteristics of the body, the presence of various diseases and many other factors.

When a woman carries twins under her heart, her subconscious begins to panic in advance, so her mood changes very quickly. It’s hard to do even light physical activity, it’s very difficult, shortness of breath simply doesn’t give me rest even at night.

In conclusion, it is worth noting that when a woman finds out about pregnancy, she should immediately visit a doctor, because traditional medicine methods may not be entirely reliable, and specialists will immediately, after an ultrasound examination, accurately determine that there are twins in the pregnant woman’s tummy.

One of the wonderful moments in the life of every woman is the news of pregnancy; there are several months of anticipation, excitement and, finally, a joyful meeting at the end of the journey. However, the news that two “bellies” have “settled” in the belly at once does not bring every mother into indescribable delight, because a woman in such a situation becomes afraid for the successful course of her pregnancy. But you shouldn’t worry too much, because now medicine has made great progress and, under the close supervision of qualified gynecologists, the expectant mother will be able to safely carry her babies. The most important thing is to recognize the signs of twins in the early stages of pregnancy as early as possible in order to promptly begin to monitor the process of fetal development and monitor the well-being of the mother. So, what are these signs?

Heredity comes first

If a young mother has already experienced a similar happy phenomenon in her family, then you need to be prepared for the birth of twins to happen again in a young family. This phenomenon is not always natural, and does not mean at all that it will be observed in all relatives. Most often, twins are born within a generation due to heredity.

We hibernate

Many pregnant women experience increased sleepiness in the first stages of pregnancy, but, of course, all this is individual. As for expectant mothers who are expecting twins, many of them noted increased sleepiness in the first couple of months, so much so that they literally fell asleep on the go.

Oh, this toxicosis

Toxicosis causes a lot of trouble for expectant mothers. For those women who still don’t realize they have two babies in their tummy, toxicosis can be very strong. It is worth saying that everything depends on the individual characteristics of the body and this is not a 100% guarantee that there are two fruits in your tummy at once.

Very bright

How, most often, does a woman find out about an interesting situation? The absence of menstruation on time prompts her to take a test and two lines indicate that in 9 months a new person will appear in the family. A sign of twin pregnancy in the early stages is two brightly colored stripes on the test, most often in mothers expecting one baby, the second stripe is too pale or invisible.

And what about the appearance?

With the onset of pregnancy, any woman experiences a global restructuring of her body, a real hormonal “explosion,” which naturally affects her appearance. Being pregnant with two children at once, such changes in appearance can be expressed even more clearly, these include:
- pigment spots on the face;

acne and pimples on the skin of the face and back;
change in skin color;
hair loss;
in rare cases, papillomas appear on the body.

Belly like a watermelon

The belly of a mother who is carrying twins in her final stages is simply huge and it seems that there really is a huge watermelon there. What about in the early stages? Women who are pregnant with twins at once notice that their stomach, which was flat up to this point, begins to grow by leaps and bounds.

In addition, they note that they begin to feel movements much earlier than the due date. This happens because two fetuses take up much more space and, of course, the belly has to expand. As for the movements, two babies create twice as many movements and, willy-nilly, you will feel them much sooner than if there was only one baby.

Why so much

It is quite natural that a mother who is carrying two children under her heart will gain more kilograms than a woman expecting one baby. According to average standards, in the first three months a woman gains weight from one and a half to 2.5 kilograms. For those lucky women who are expecting twins, these weight indicators can be safely multiplied by two!

The older, the more!

It is so inherent in nature that the older a woman gets, the greater the likelihood of receiving double joy at conception. If you are over 35 years old, then the probability of being a “mother squared” in one birth is high!

What will the doctors say?

Doctors, for their part, can also detect twin pregnancies quite early.

Distinctive signs of multiple pregnancy

Signs of twin pregnancies in the early stages of pregnancy, which can be pronounced, are:

Your belly will tell you everything

Doctors always note the appearance of a characteristic horizontal stripe on the stomach of a woman pregnant with twins.

The first ultrasound most often dispels all the guesses and doubts of both the mother and the doctors. Although there are also cases of errors when the ultrasound specialist simply did not notice the second fetus.

When two hearts beat together

Experienced doctors, listening to the belly of the expectant mother, clearly distinguish the beating of two small hearts at once.

Skillful hands

During palpation, the obstetrician-gynecologist leading the pregnancy can feel the two heads and two pelvises of the developing fetuses.

Strange word - fano electrocardiography

A similar procedure is carried out closer to the 20th week of pregnancy, and thanks to it, doctors can clearly distinguish the beating of two hearts, which certainly confirms a multiple pregnancy.

Test – alphafetoprotein

A similar test is carried out during the transition from the 1st to the 2nd trimester of pregnancy and is done in order to identify possible abnormalities in the fetus. If you are pregnant with two fetuses, the test result will be very high.

Stimulation

If pregnancy does not occur for a long time, and doctors take any measures to stimulate it, then in most cases several eggs ovulate at once, which subsequently leads to multiple pregnancies.

Stopping taking contraceptives

Prevention with hormonal oral contraceptives for a long period of time suppresses the functioning of the ovaries. After stopping taking them, the ovaries begin to work at full capacity, making up for lost time, and often produce several eggs at once.

As you can see, dear readers, the signs of twins in the early stages of pregnancy are quite varied, they can be both medical and everyday. It is important for the expectant mother to listen to her own feelings, visit an obstetrician-gynecologist and an ultrasound room to find out for sure how many babies are in her growing belly. Good luck with your pregnancy and safe delivery! See you soon in new articles!

In recent years, there seem to be more mothers with strollers for twins on the street.

This is true. Modern methods of reproductive medicine help future parents find their little happiness in double, and sometimes triple and even quadruple size.

However, according to statistics, the probability of a woman independently conceiving two babies at once is a rare phenomenon: in Russia - about 1% of all pregnancies. And, basically, in 99% of cases, these are twins. Triplets are extremely rare - 1% of multiple pregnancies. The birth of more than three children at the same time is a unique and isolated case.

The phenomenon when a pregnant woman expects the birth of two or more babies at once is called multiple pregnancy.

In the medical world, multiple pregnancies are classified according to certain criteria.

Number of simultaneously gestated fruits

Depending on how many embryos the expectant mother carries at the same time, pregnancy can be:

twins;
triplets;
quadruplets, etc.

The most prolific mother in history was a Brazilian woman who gave birth to ten children, who, however, did not live long.

Number of zygotes formed during fertilization

Depending on how many eggs released simultaneously from the follicle were fertilized by sperm, pregnancy can be:

monozygotic (identical twins) - if the conception of twins occurred during the fertilization of one egg;
heterozygous (multi-zygotic twins) – if the conception of twins occurred through the fertilization of different eggs.

The presence of chorion and amnion for each fetus

Depending on how separated the twins are from each other in the mother's womb, pregnancy is distinguished:

heterochorionic heteroamniotic - each fetus is in its own amniotic sac and attached to its own placenta;
monochorionic heteroamniotic - each fetus is in its own amniotic sac, but their umbilical cords are attached to the common placenta;
monochorionic monoamniotic - embryos are located in a common amniotic sac and are attached to a common placenta.

The specificity of each type of multiple pregnancy according to the above characteristics is formed due to differences in the mechanism of its occurrence and development at a very early stage.

How does multiple pregnancy occur?

The mechanism for the development of multiple pregnancy can be twofold.

Fraternal pregnancy.

Fraternal pregnancy occurs when two (or more) sperm fertilize two (or more) eggs, possibly due to different sexual acts.

This occurs if, as a rule, during one menstrual period, two (or more) dominant follicles mature (in one or both ovaries).

“As a rule” - because the characteristics of some multiple pregnancies give reason to assume that the conception of one of the twins occurred in the next ovulatory cycle.

Fraternal pregnancy is always heterochorionic heteroamniotic. And twins can be completely different from each other after birth, since they receive a different genetic makeup at conception.

Identical pregnancy.

Such a pregnancy occurs if a sperm, as expected, fertilizes one egg, which, however, some time after fertilization is divided into two (or more). Babies conceived from the same seed receive an identical set of genes.

Moreover, the period at which the division occurred determines whether the twins will have chorions (placental precursors) and amnions separate from each other.

If the zygote divides no later than three days after its formation, then the further development of pregnancy will take place according to the heterochorionic heteroamniotic type.

If the division of the egg after meeting the sperm occurs during the formation of the chorion (on days 3–8), a monochorionic heteroamniotic pregnancy is formed.

If the zygote divides between the 8th and 13th days after its formation, a monochorionic monoamniotic multiple pregnancy occurs.

The process of full division of a fertilized egg in later stages of pregnancy cannot be completed and leads to an abnormal development of embryos called “Siamese twins” - babies fused with body parts.

In general, multiple births are a phenomenon unusual for the human reproductive system; it is impossible to predict, and the reasons are still unclear.

The only explicable cause of multiple pregnancy at the moment can be considered artificial intervention in a woman’s reproductive system:

conception using IVF, in which several already grown embryos are implanted into a woman’s uterus to increase the chances of consolidation of at least one embryo;
stimulation of superovulation with hormonal drugs to obtain several mature eggs in one period and increase the chances of pregnancy.

The facts of a different origin of multiple pregnancy remain uncertain, however, factors for the increased likelihood of multiple pregnancy have been identified:

Age.

In women who become pregnant over the age of 35, multiple births are more common than in younger mothers. This is explained by fluctuations in hormonal levels due to the beginning restructuring of reproductive function.

Hereditary.

For parents with a family history of twins, triplets, etc., the likelihood of multiple conception increases. Moreover, the inheritance of multiple births can be on both the maternal and paternal sides.

Rebound effect.

According to observations, the likelihood that conception occurring during the first ovulatory cycle, after discontinuation of long-term (more than six months) use of oral contraceptives, will be multiple, increases;

Lactation period.

It has been noted that during breastfeeding, the likelihood of multiple pregnancy increases;

Ethnic.

According to statistics, the Negroid race has the highest rate of giving birth to several children at once. This is associated with the peculiarities of their national diet.

The structure of the uterus.

It has been noted that pregnancy that occurs with a “bicornuate” or “bifurcated” uterus is more often multiple-fetal than with a normal uterine structure.

However, the simultaneous conception of more than one fetus, naturally, even if the expectant mother is included in the “risk group,” remains a rather rare occurrence and carries the risk of complications during pregnancy and childbirth, as well as in the postpartum period, both for women and for kids too.

Signs and symptoms in the early stages

An experienced mother, finding herself once again in an interesting situation, may note some changes in well-being, more pronounced than during a singleton pregnancy:

chronic fatigue and drowsiness;
pronounced;

And you may find that:

The “positive” strip is as bright as the control strip.

It is likely that these are signs of multiple pregnancy, which require confirmation by a gynecologist.

With the development of multiple pregnancy, its fact becomes more and more obvious. The following symptoms occur:

the size of the abdomen is ahead in terms of timing for a singleton pregnancy;
identification by touch of more than two large parts of the body (baby’s head and buttocks);
fruit movements already at the beginning of the second trimester;
When listening to heart rhythms, more than one source is detected.

More recently, based on the described manifestations, doctors were able to understand that their patient was expecting several babies, however, this often became reliably known only in late pregnancy, and sometimes only during childbirth.

Fortunately, modern diagnostic methods, especially using ultrasound, allow doctors to diagnose multiple pregnancy in the first weeks of pregnancy.

Possible complications

The unusual load that the female body experiences when carrying several babies, as well as the conditions for the joint existence of fetuses in utero, allow us to consider multiple births as a complication of pregnancy.

Complications of multiple pregnancy can manifest themselves both through the condition of the expectant mother and through the well-being of the babies.

Complications for twins

spontaneous termination of pregnancy: depending on the period - miscarriage or premature birth and related complications;
prenatal death, stillbirth of one or all fetuses, due to any pathologies during the gestation period or during childbirth;
intrauterine developmental delay in all or one of the babies;
anomalies in the placement of the umbilical cord (including the so-called “pigtail syndrome”);
improper placement of fetuses in the uterus;
obstetric collision.

During childbirth: coupling of large parts of the body of the twins at the exit from the pelvis;

other injuries received by babies at birth, often occurring during multiple births;
congenital anomalies of varying severity in one or all twins;
feto-fetal transfusion syndrome.

Develops during pregnancy with monochorionic multiple births. In the common placenta, anastomoses-vessels can form, closing the fetal blood flow into a single one. In such a “circle,” the flow of arterial and venous blood between the fetuses may be disrupted, leading to the suffering of the babies.

phenomenon of the missing twin.

An event meaning that in the early stages of a multiple pregnancy, spontaneous reduction of one of the twins occurred, for some reason.

Complications for women

The risk of developing maternal health complications associated with twins increases with the length of pregnancy. This is especially true for pregnancies resulting from conception using reproductive medicine methods.

Mothers expecting twins most often experience:

, which first appeared during the current pregnancy;
early and late, which are usually more severe than when carrying one baby;
rupture and, due to perforation of the membranes or their premature rupture;
overstretching of the muscle fibers of the uterus and associated complications during childbirth and the postpartum period;
exacerbation of chronic diseases;
intrahepatic cholestasis induced specifically by multiple pregnancy, as well as:
decreased glucose tolerance.

In addition, with multiple pregnancies resulting from IVF, there is a risk of:

heterotopic pregnancy.

A rare complication in which one of the implanted fertilized eggs, having failed to gain a foothold in the uterine cavity, is established outside of it.

Thus, a normal uterine pregnancy and, dangerous for the woman, an ectopic (ectopic) pregnancy occur simultaneously. As a rule, an incorrectly attached embryo is removed in the early stages.

However, a case was recorded when a heterotopic pregnancy was discovered only at the 28th week and, through the efforts of doctors, both the mother and the twins were saved.

Diagnosis of multiple pregnancy

Currently, diagnosing multiple pregnancies just a few weeks after conception is not at all difficult.

How to determine using ultrasound?

The gold standard in establishing multiple pregnancy carried by a pregnant woman is an echographic examination.

You can see the number of embryos in a woman’s uterus on the screen as early as the 5th week of pregnancy.

And a little later, determine the nature of multiple pregnancy, listen to the babies’ heartbeats, and evaluate the features of their development.

The reliability of ultrasound results for diagnosing pregnancy with more than one fetus is over 99%, and inaccuracies are rare and mainly relate to the exact number of twins (triplets, quadruplets, etc.).

Biochemical blood test indicators

Indirectly indicating the onset of a multiple pregnancy, or, more precisely, of course, the onset of a multiple heterochorionic pregnancy, may be produced by chorionic tissue.

The multiplicity of excess hCG values in the blood of the expectant mother of twins, compared with the norm for indicators during pregnancy with one fetus, corresponds to the number of embryos (that is, their chorions) in the uterine cavity. But the increase in hCG values in accordance with the stage of pregnancy will be standard.

All indicators of biochemical blood tests performed during screenings will be overestimated (this applies to PAPP-A, AFP, and estriol).

However, high values of blood markers may simultaneously indicate intrauterine pathologies in the development of embryos or one of them.

Therefore, the only reliably informative source for diagnosing “multiple pregnancy” can be considered the data from the ultrasound protocol. Ultrasound is also of particular importance in identifying symptoms of developmental defects in babies.

Early diagnosis of multiple pregnancy plays a role in choosing a medical approach to pregnancy management specific to multiple pregnancy.

Features of managing multiple pregnancies: what are the risks?

First of all, the future parent herself, when carrying twins, triplets, etc., must take increased responsibility for compliance with the instructions for mothers with multiples:

refrain from physical and emotional activity, and in late stages of pregnancy tend to adhere to bed rest;
monitor the sufficient calorie content and quality of your diet;
accept .

The observing doctor will pay special attention to a mother carrying multiple births:

a more dense schedule of scheduled appointments and examinations than during a normal pregnancy (for a normal pregnancy: twice a month until the 28th week, and after issuing a certificate of incapacity for work - at least once every one and a half weeks);
in general, a wider list of indications for issuing sick leave and hospitalization of a woman with a multiple pregnancy;
prescribing iron-containing dietary supplements for the prevention and treatment of anemia in pregnant women;
referral for consultation to a therapist and specialized medical specialists if a woman is registered with a medical institution due to a chronic disease (at least 3 times during pregnancy);
prescribing tocolytic drugs for the prevention of miscarriage and miscarriage;
prescription of drugs that improve utero-placental-fetal circulation;
more frequent than during normal pregnancy, referral for ultrasound, for dynamic assessment of the development of babies and the quality of their life;
more frequent referrals for ultrasound than during normal pregnancy to assess the risk of miscarriages, premature births, pregnancy complications, etc.
referral to the hospital of the expectant mother of twins in advance - 2 - 4 weeks before the expected delivery, due to the frequency of premature labor.

Managing the delivery of a multiple pregnancy carries an increased risk of complications and also has its own characteristics.

Management of childbirth

Often, the method of choice for delivery of a pregnant woman with multiple pregnancies is a cesarean section.

In addition to the general indications for the surgical method of childbirth management, multiple pregnancies are delivered through cesarean section if:

the fetus closest to the exit of the uterus is not in a cephalic presentation. In practice, a caesarean section is often performed if at least one baby is in a transverse, oblique or breech presentation due to the risk of obstetric collision.

Although, with sufficient experience of the obstetrician leading the birth, after the successful birth of the first baby head first, it is possible to manually turn the second fetus into the head position (under ultrasound control) and deliver it naturally;

a woman is carrying three or more children, and also, in case of twins, if the total weight of the babies in the womb is more than 6 kg. In this case, due to the risk of complications due to overstretching of the uterus, a planned operation is performed at 34–35 weeks;
a woman is carrying monochorionic twins, since there is a high risk of complications during natural childbirth inherent in this type of pregnancy. In case of monochorionic monoamniotic multiple pregnancy, in which the risk of complications is greatest, early delivery is recommended at 33–35 weeks of pregnancy.
a woman is carrying “Siamese twins”;
in the absence of indications for a planned cesarean section, nevertheless, complications developed during natural childbirth that required emergency delivery of the woman.

When conducting natural childbirth in the case of multiple pregnancies, in order to reduce the time interval between the birth of the first and subsequent fetuses, immediately after the birth of the eldest baby, the amniotic sac of the next baby is pierced and labor is stimulated.

The probability of unforeseen unfavorable developments during a multiple birth naturally is several times higher than a normal birth, therefore, as a rule, such births are carried out against the background of readiness for emergency surgical intervention.

Embryo reduction

In the last thirty years, to reduce the risks of complications during multiple and superfetal (more than three embryos) pregnancies and prenatal and maternal mortality as a result, the embryo reduction method has been used.

The use of reduction is especially relevant during induced pregnancy, as it is most susceptible to complications.

The optimal pregnancy period for the procedure is 7–11 weeks.

Indications for reduction include a superfetal pregnancy or identified malformations of one of the babies. However, at the request of the expectant mother, it is possible to reduce embryos in twins or triplets to a singleton pregnancy, although, in this case, the threat of miscarriage of all embryos exceeds the threat of their mortality during the gestation period.

The selection of embryos to be reduced is carried out according to certain criteria by the doctor, in agreement with the patient.

Mandatory conditions for carrying out the procedure are compliance with the necessary sanitary, technical, legal standards, as well as the possibility of attracting a specialist with the appropriate skills and knowledge to carry out the operation.

Multiple pregnancy is undoubtedly a great test, both for the expectant mother and for the babies themselves, who are forced to fight for survival even before birth.

It is impossible to predict multiple pregnancy, as well as to guarantee its successful pregnancy and delivery. Therefore, future parents of twins can only trust the doctors and trust in fate.

As a rule, multiple pregnancies are observed in those who have undergone artificial insemination (IVF) or the lucky ones who have already had twins or triplets in their family. If you have dreamed so much about twins or triplets, and at least one of these factors has been taken into account, then you want to know about this event as early as possible. It is for this reason that today we will look at the signs of twins in early pregnancy.

The doctor will be able to please you with this news only after an ultrasound examination, and then not the first, but already in the second trimester of pregnancy. But in this situation, special medical supervision is needed.

So, what is a multiple pregnancy and what signs of a twin pregnancy can an expectant mother notice in the early stages? This is the carrying of two, three, four or more babies in the womb. Let's immediately note the statistics: in Europe, the rate of multiple pregnancies has now increased to 1% under the influence of IVF. Currently, 1 out of 89 pregnancies is multiple.

Early signs

To begin with, in this section we will list the conditions that increase the chances of several babies being born at once. These include:

Age from 35 years (this is a scientifically proven fact, the whole point is that with age there is an increase in the hormonal levels responsible for the maturation of eggs).
Genetic factor (if there have already been such cases in the family, then the chance of becoming a happy mother of several babies at once increases).
Malfunction of the ovaries (approximately once every 200 menstrual cycles a malfunction occurs - the maturation of 2 eggs at once).
In vitro fertilization (for a greater likelihood of a successful outcome of the procedure, several fertilized eggs are implanted into the woman at once).
Stimulation with the help of certain drugs (they enhance the work of the ovaries, and this is how the formation and maturation of 2 eggs occurs at once).
Refusal of OK - oral contraceptives (when taken, a hormonal background is created, as during pregnancy, the ovaries rest, and refusal to take it contributes to increased work of this organ).
Large family (the more children a woman has given birth to, the greater the chance of having twins).
Men from the Middle East and Africa are more likely to have twins (an ethnic feature).
The duration of the menstrual cycle, which is 21 days, contributes to the occurrence of multiple pregnancies.
Bicornuate uterus (this organ pathology leads to the formation of two eggs at once).

The classic version of pregnancy is carrying 1 fetus. But carrying several children creates additional stress on a woman’s body. For this reason, every expectant mother should know the signs of twins in the early stages. These include the following:

genetics (note that re-birth of twins or triplets is possible after a generation);
on the test that women carry out at home, the second strip will be very clear and bold, which indicates a high level of hCG;
very strong drowsiness;
severe toxicosis;
acne may appear, which becomes possible due to the large amount of hormone production;
rapid growth of the abdomen;
early and active movements.

Medical confirmation of multiple pregnancy

The above signs of twins, which the mother herself can note even before a visit to the gynecologist, are not always easily tolerated by a woman. If you notice these signs, notify your doctor.

Here are the signs that a gynecologist may notice during a multiple pregnancy:

horizontal furrow separating babies;
deepening of the uterine fundus;
detection of 4 large parts upon palpation of the abdomen (two heads and two pelvises);
Ultrasound at 12 weeks of pregnancy;
phonoelectrocardiography (the beating of two hearts at once is noted);
when listening, the heartbeat is noted in different places;
the AFP test in the second trimester of pregnancy is not just positive, but quite high (a test for detecting abnormal fetal phenomena).

Fatigue

Above, we highlighted a number of signs of twins in the early stages that the expectant mother herself can detect; now we’ll talk about them in more detail. Let's start with increased fatigue. It is important to note that expectant mothers of twins, triplets, and so on literally sleep on the move (sitting, standing, lying down). This can be noticed even at the stage when they are not even aware of their pregnancy (that is, from the first day of fertilization).

During pregnancy, lethargy, fatigue and drowsiness, especially in the first trimester, are normal, but during multiple pregnancies they literally double.

If a woman is already expecting another child, then she will easily feel the difference, but for a first-time mother, her condition is not always clear. How can you easily recognize twins based on this sign? If you have a pregnant friend, you can see her fatigue, but she still flutters around, enjoys life, and so on, and for you getting to work is a real feat, then most likely you are expecting twins. However, it is worth excluding many more factors that contribute to severe fatigue:

stress;
poor nutrition;
heavy workload and so on.

Morning sickness

Another sign of twins is morning sickness. Please note that this will not necessarily be severe nausea or vomiting with a vengeance, it may simply be a loss of strength that goes away by the middle of the day.

As for toxicosis, it is worth remembering that each organism is individual. Some happy mothers of twins and triplets felt just great during pregnancy. And those who are expecting one child may experience very severe discomfort due to severe toxicosis. If you feel great, this is not an indication that you are carrying only one baby in your womb.

Don't forget about women's intuition, which is greatly aggravated during pregnancy. The expectant mother can feel for herself how many children she has and what gender they are.

Movements

Another sign of twin pregnancy is early movements. As a rule, a mother first feels her baby move only at the nineteenth week. If you are pregnant for the second time or more, you may feel tremors as early as the sixteenth week.

Often, women who are expecting two or more children experience earlier and more intense movements. In addition, during multiple pregnancies, there is a discrepancy between the size of the uterus and the delay in menstruation. At a later date, the doctor will be able to determine the number of babies by palpating and listening to the tummy. Please also note that movements during multiple pregnancies are not at all different from those that mothers feel when carrying one baby.

hCG

When you take a pregnancy test, it is human chorionic gonadotropin that alerts you to an “interesting” situation. After you are registered with a gynecologist (starting from the tenth day after fertilization), the doctor constantly monitors the level of this hormone throughout pregnancy. One of the most common signs of twins is high hCG levels.

In addition, mothers who are expecting twins gain about five kilograms more weight than women pregnant with one baby. However, please also note that this is not the only factor influencing weight gain. Pay attention to your diet; in this situation it is better not to overeat. Eat less, but more often, and be sure to watch your diet, because the baby’s well-being now also depends on it.

Gestational age

Another sign of twins in early pregnancy is a high gestational age. What it is? When you visit your gynecologist, he will definitely measure the distance between the top of the uterus and the top of the pubis. This is necessary to determine the gestational age of the baby.

If you have a multiple pregnancy, the uterus expands more, therefore, the indicator increases. But we should not forget that this is not the only reason for this phenomenon. This is why it is important to visit your doctor regularly.

AFP

How else can you recognize a multiple pregnancy without an ultrasound? We looked at quite a lot of signs of twins in the article, but the AFP test went unnoticed. It is done to detect birth defects in a child. Don't be alarmed if the result is quite high or positive, this often happens with multiple pregnancies. An ultrasound is required to confirm the result.

Please note that twins are not always visible on the first ultrasound. Although there were many cases when multiple pregnancies were detected as early as the sixth week. At week 22, there is already a higher probability that the doctor will detect several babies on an ultrasound. A mistake at this time occurs only if the mother is expecting five or more children.

Risks of multiple pregnancies

We examined in detail the first signs of twins, which the mother herself can notice without consulting specialists. Now let's move on to the question of why, especially during multiple pregnancies, you should definitely visit your doctor regularly?

The risks directly depend on the connection between the membranes, placenta and twins. Every third multiple pregnancy is monochorionic (babies share one placenta). Among them:

more than 30% - dichorionic-diamniotic (two umbilical cords, thick septum between children);
more than 60% - monochorionic-diamniotic (thin septum);
2% - monochorionic-monoamniotic (common amniotic sac and placenta).

In the first case, the risks are minimal if the first child has a cephalic presentation. This case does not require special medical supervision. In monochorionic-diamniotic twin pregnancies, there is a chance of developing feto-fetal transfusion syndrome. The mother is recommended to undergo control examinations twice a month. The most difficult and dangerous case is the third. Here, babies run the risk of their body parts growing together (Siamese twins) or intertwining their umbilical cords. Frequent ultrasound examinations are necessary, and a caesarean section is required for childbirth.

Features of pregnancy

If you listen to the recommendations given by your doctor, you will spend this time no less happily than women expecting one child. Since during a multiple pregnancy a double load is immediately placed on the mother’s body, doctors pay closer attention to you.

When you are expecting two or more babies, there is a high probability of miscarriage or premature rupture of amniotic fluid. This is especially true in recent months. Don't overexert yourself or do heavy physical work. Some are recommended bed rest or hospitalization.

As a rule, twins are born earlier (at 36 or 38 weeks). Their weight is less than that of other children, however, they are distinguished by their increased ability to adapt. The weight and abdominal circumference will be slightly greater than for women expecting one child.

Be sure to watch your diet and consult your doctor about taking vitamins and mineral complexes. During a multiple pregnancy, the body can quickly deplete its reserves.

Well-being, the shape of the tummy and rapid weight gain will tell the expectant mother not only the gender of the child, but also the number of embryos in the womb. Any woman can identify this on her own if she carefully listens to the symptoms: toxicosis, fatigue, dizziness and the need to eat certain types of foods. All these signs intensify if two full-fledged fetuses develop inside: twins or twins. At the first examination, when a woman is registered, a gynecologist can identify two or more embryos based on the condition and size of the uterus, which increases several times with twins, and an ultrasound will then confirm the doctor’s assumption.

How does a doctor determine twins without an ultrasound?

Multiple pregnancies have become not uncommon; they are largely due to genetic factors. An expectant mother, receiving information about twins in the second trimester, receives serious stress, because she is already accustomed to thinking about one child, and the equipment shows that there will be twins or twins. How to determine twins without an ultrasound at the first examination by a gynecologist? All signs can be divided into two categories: intuitive and scientifically based. The latter includes tests and visual examinations by specialists.

For example, twins will be immediately indicated by the increased size of the uterus and a sharp jump in the hCG hormone, which occurs only in pregnant women: with a norm of 3, its value will double, since there are also two pregnancies.
Screening will show a high protein content in the AFP test, and a double heartbeat, which can be heard using a special Doppler system already in the eighth week of pregnancy, is a clear confirmation of the fact of multiple pregnancy.
In the early stages, an ultrasound may not show two embryos, since one will hide behind the other, but during the examination, the doctor will palpate two fetuses and notify the woman.

Symptoms of twins in pregnant women

Of course, the well-being of the expectant mother is attributed more to intuitive factors than to reliable ones. And its symptoms are rarely associated with who will be born and how many children there will be. A woman with a second pregnancy can say exactly what severe toxicosis is: if there are two inside, nausea can lead to vomiting.

Since the uterus grows from the inside, the tummy will grow from the outside, by leaps and bounds, and by the end of the first trimester it can be compared with those who have already gone on maternity leave. At the same time, the weight grows as quickly as the stomach.
With twins, movements begin earlier than the expected period of 20 weeks. It is interesting that two children move at once; this creates incredible discomfort for the mother, because she needs to take a position that is acceptable for both of them.
With multiple pregnancy, the mammary glands increase by 2-3 sizes, touching them is unpleasant, as the breasts become heavy and “filled up”.
Daily physical activity will make itself felt by constant shortness of breath, because from the first days the diaphragm begins to rise upward, making room for growing babies.
Even if your belly is growing at a rapid pace, and the doctor has not yet identified twins, find out more about your genetic line: were there twins in your family, twins, or in your spouse’s family? If yes, then the probability of giving birth to two immediately increases.

Many people say that ultrasound is harmful, so they don’t go for an examination as a matter of principle, although 3 diagnostic tests during pregnancy are considered mandatory. If you think that you are losing weight, you feel disgusting, and at three months your belly is simply bulging, do your own palpation: while walking, place two hands on your lower abdomen; if you have twins, then the heads on both sides will be clearly palpable , and the shape of the tummy below will be square.