Problems That May Occur in Multiple Pregnancy

Multiple pregnancy is the condition of having two or more pregnancies in the womb is frequently seen as a result of multiple embryo transfers in IVF treatments. Although the aim of embryo transfer is to increase the chance of success, it is limited by law due to the risks of multiple pregnancy.

The diagnosis of multiple pregnancy can be detected early with ultrasound, thanks to today's facilities. This diagnosis is made when more than one gestational sac is seen in the uterus. However, every pregnancy that starts as a multiple pregnancy may not continue as a multiple; a fetus may not form in one sac and the heartbeat may not start, but this does not pose a problem in the healthy development of the other pregnancy.

Multiple pregnancies are generally not a problem, but there are risks to the health of the mother and the babies.

What are the problems that can occur in multiple pregnancy?

• In multiple pregnancies, nausea, tendency to sleep and feeling tired are very common in the early period. Nausea and vomiting are more and more severe due to the excessive secretion of Bhcg, the pregnancy hormone, in multiple pregnancies.
• In the following weeks of pregnancy, mechanical compression, which is caused by both the enlargement of the uterus and the excess amniotic fluid, causes complaints such as difficulty in walking, shortness of breath and low back pain in mothers with multiple pregnancies.
• The risk of anemia in the mother increases, because pregnancy hormone has a blood volume-increasing effect, and this effect is more pronounced in multiple pregnancies. Since the increase in blood cells is not at the same rate, anemia occurs due to the dilution of the blood. Iron supplements should be started early in mothers with multiple pregnancies.
• Gestational hypertension is also common. It starts earlier and progresses more severely. The reason for this is not known exactly. Expectant mothers should be informed about this issue and should have information about their symptoms. Blood pressure monitoring should also be done frequently.
• The risk of preterm birth and miscarriage increases. In multiple pregnancies, the gestation period is shortened in proportion to the number of babies. The average gestation period is 36 weeks for twins, 33 weeks for triplets and 29 weeks for quadruplets.
• Placental anomalies are found. Placental anomalies and premature separation of the placenta are more common in multiple pregnancies. And it is one of the most dangerous situations. The communication channel between the baby and the mother loses its contact and the baby's development cannot be achieved.
• Cesarean deliveries are on the rise. Multiple pregnancies are in the risk pregnancy group. In cases where the pelvic structure is suitable and if the babies are head-to-head, normal birth can also be done, but today, cesarean section is preferred in multiple pregnancies.
• It can lead to the inability of the uterus to recover after delivery. This creates the risk of bleeding.
• In multiple pregnancies, the frequency of congenital anomalies in babies is slightly higher than in single pregnancies.
• During pregnancy, the hospital stay of the mother and the baby after birth is longer in terms of precautions and interventions.

What should be considered in multiple pregnancies?

• The risk of preterm birth is higher, the risk of miscarriage is higher. It carries risks even during childbirth. Since there are more than one factor that forces the woman's metabolism, it is necessary to be under the control of a doctor constantly.
• Mothers with multiple pregnancies need more iron. Iron is an essential nutrient for blood formation in infants. Therefore, it should be taken both with food and externally as a supplement.
• Calcium should likewise be supplemented. If not enough calcium is taken, babies will use the calcium in the mother's bones and cause bone destruction.
• For the physical development of babies, it is also important for the mother to take fluids. Therefore, you need to drink plenty of water.
• You should use the vitamins recommended by your doctor regularly.
• Especially mothers should not get tired mentally and physically. The negative effects of excessive stress are quite effective. Mothers who are under stress make their babies feel this pressure as well. In this case, the babies being affected may cause some problems. Therefore, it is very important that you have a calm and peaceful pregnancy.
• It would be the right decision to take maternity leave from the 30th week of pregnancy in order to reduce the risk of preterm birth for working mothers. Mothers should go to the doctor more often and be under constant control. Mothers with multiple pregnancies are more likely to be hospitalized. Therefore, risk factors need to be constantly controlled. Since the risk of anomalies is high in these babies, follow-up is important.

What problems can be seen in babies born with multiple pregnancies?

The most important risk in multiple pregnancies is premature babies, that is, very premature births. In scientific studies, it has been proven that preterm birth is high with multiple pregnancies. Twin babies have a 50% risk of being born prematurely. If the number of babies is more than twins, this rate goes up to 90%. In addition, serious health problems may occur in babies born prematurely due to multiple pregnancies.

These problems are;

• If babies are in the same placenta, they cannot be fed adequately.
• They grow slower compared to normal babies.
• Babies who have to be born prematurely due to multiple pregnancies experience respiratory distress as their lungs cannot develop sufficiently.
• Babies born in multiple pregnancies are born very weak and weak. This can lead to illness and sudden death.
• Babies born with multiple pregnancies may have abnormalities in brain and nerve functions. The most common abnormality is problems in the brain.

How to prevent the risk of multiple pregnancy?

Since multiple pregnancies are usually seen in in vitro fertilization treatments, the dose of the drugs used in the treatment of infertility should be adjusted well by the doctor. With hormonal drugs used in the treatment of infertility , more eggs are produced than normal. Excessive egg production means an increased risk of multiple pregnancy. In some cases, the treatment may even be canceled against the risks that may occur. Embryo selection and transfer in IVF applications should be performed with one or two embryos. Because with one or two embryo transfers, the risk of multiple pregnancy is prevented. For this reason, the treating physician should be very careful in embryo selection and transfer.

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