Multiple pregnancy in the uterus there are two or more pregnancies. In recent years, the incidence of multiple pregnancies has increased with the frequent application of reproductive methods.
The diagnosis of twin pregnancy can be made in the early period by the widespread use of ultrasound. The diagnosis is made by seeing more than one gestational sac in the uterus. However, any pregnancy starting as a twin pregnancy may not continue as a twin; The fetus may not form in a sac and the heartbeat may not start, but this does not preclude the healthy development of the other pregnancy.
Twin pregnancies are at risk for both mothers and infants. In twin pregnancies, early nausea, tendency to sleep, and feeling of fatigue are more common. Nausea and vomiting are more severe because of the excessive release of Bhcg, which is the pregnancy hormones in twin pregnancies. Twin pregnancy should be considered in patients with severe nausea and vomiting in early pregnancy. In the following gestational weeks, mechanical pressure caused by both uterine enlargement and amniotic fluid causes complaints such as difficulty in walking, shortness of breath and low back pain. The mother’s risk of anemia increases.
Anemia occurs depending on the water is watered. In pregnant women with twin pregnancies, iron preparations should be started early. Pregnancy hypertension (Preclampsia-eclampsia) is more common. It starts earlier and is more severe. The risk of premature birth and miscarriage increases. In twin pregnancies, the duration of pregnancy is proportional to the number of infants. The mean gestational age in twins is 36 weeks, in triplets 33 weeks and in quadruples 29 weeks. Placentation of the placenta and premature detachment of the placenta are more common in multiple pregnancies. Caesarean incidence increases. Twin pregnancies are in a risky pregnancy group. The risk of bleeding increases due to inability to recover the uterus after delivery. In twin pregnancies, the incidence of congenital anomalies in infants is slightly increased compared to singleton pregnancies. The duration of hospitalization of the mother and the baby after pregnancy increases.
Pregnancy controls should be done more frequently in twin pregnancy. A part of pregnancies starting as twin pregnancies can continue as singleton. In the first half of pregnancy, one of the babies died in the uterus. Maternity candidates should be checked every 15 days from the second trimester and once a week from the third trimester in terms of the risk of premature birth. In twin pregnancies, 11ler14 is used to determine the baby’s health. week and 16–18. We do not recommend blood tests for weeks. In twin pregnancies, multivitamin and iron preparations should be increased and extra calorie diet should be given. In twin pregnancies, expectant mothers should interrupt the study and avoid exercise after the 28th week.
The mean gestational age in twin pregnancies is 36 weeks. The symptoms of premature birth risk should be explained to maternal candidates and patients should be followed up frequently. In terms of risks associated with premature delivery, hospitals with infant-intensive care should be preferred. If there is a difference between the babies in terms of development, twin to twin transfusion syndrome should be considered if amniotic fluid quantities are different and the patient should be followed in risky pregnancy units. A good ultrasound evaluation is very important in twin pregnancy follow-up.