A Pleasant Surprise, Multiple Pregnancy

Multiple pregnancies throughout human history ( twin and triplet pregnancies ) aroused interest and became the subject of many legends. This situation, which has become more common with the increasing prevalence of assisted reproductive techniques today, is a surprise for most families. Due to the special risks they carry, they require more careful and close follow-up throughout pregnancy.

Multiple pregnancy Two-thirds of ovarian cells result from the fertilization of more than one egg cell (oocyte) with the same number of sperm. In this case, known as fraternal twins, there are genetically different embryos. One third of multiple pregnancies are known as identical twins; When a fertilized egg undergoes division during its development, more than one embryo with the same genetic characteristics is formed. This situation is also known as identical twins among the people.

Multiple pregnancies, which are considered as a very pleasant surprise and are seen at a rate of approximately 1 percent among all pregnancies, are a serious condition for obstetricians in terms of the risks they may bring and are examined as risky pregnancies. Multiple pregnancies as it is considered to be in the risky pregnancy category. perinatologist(high risk pregnancy specialist) is recommended.

Multiple pregnancy history in the family, maternal age over 35 years, social characteristics (eg, it is 5 times higher in African society), the number of pregnancies (twin pregnancy probability increases 2 times after 4 births) and ovulation stimulating drugs are factors that increase the probability of multiple pregnancy.

Symptoms such as nausea, vomiting, fatigue, drowsiness, urinary complaints, and appetite changes seen in a normal singleton pregnancy may be more severe in most pregnant women. Apart from these, the expectant mother gains more weight during her pregnancy (average 18 – 20 kg), anemia (anemia) is more common during pregnancy, the risk of bleeding and miscarriage is higher in the first period of pregnancy.

Among the risks for the mother, according to single pregnancies; 10-fold increase in the probability of premature birth, high blood pressure, preeclampsia (pregnancy poisoning), risk of congenital anomalies in babies, growth retardation in one or both babies in the womb, placental anomalies (spousal problems- placenta.previa, placental abruption, vasa previa), There is an increased risk of gestational diabetes, interventional delivery and postpartum hemorrhage.

This surprise, which is pleasant for the family due to such increased risks, requires attention, effort and strict follow-up for the physician from the first weeks of pregnancy. Repetition of routine blood and urine tests at regular intervals, iron, folic acid and calcium support, frequent follow-ups, follow-up of the growth of babies compatible with the gestational week and each other, detailed ultrasound to diagnose possible anomalies in babies, periodic application of fetal well-being tests, close proximity in terms of preterm birth. follow-up, timely intervention in risky situations during the follow-up process will increase the probability of a smooth pregnancy. Considering all these reasons, it would be appropriate to follow up multiple pregnancies by a perinatology specialist (high-risk pregnancies specialist).

Considering the risks for the baby and the mother while approaching the happy ending for the family, cesarean section is generally the preferred method of delivery. However, if the first and second babies are in the head-to-head position, vaginal delivery may be preferred. If the first baby is a head and the second baby is not a head; If the second baby is breech following the birth of the first, vaginal delivery can be achieved. The second baby can be delivered vaginally with the help of maneuvers made into the uterus in the side position. In both cases, cesarean section may be preferred if there is not enough experience and suitable conditions. Cesarean delivery is preferred in cases where the first baby does not arrive at the head.

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