As you probably already know by now, multiple pregnancies, such as twins, triplets and quadruplets, are considered high-risk pregnancies due to the increased likelihood of complications. In Singapore, ladies carrying multiples would typically be referred to maternal foetal medicine specialists. While many multiple pregnancies go smoothly, it’s important to be aware of the potential complications that can arise during this special time.
Here are some common complications that expectant moms of multiples may face:
Preterm labour:
Multiple pregnancies are at a higher risk of preterm labour, which can lead to premature birth and a host of associated health risks. There are several ways to combat preterm labour in multiple pregnancies, including seeking early and regular prenatal care, managing chronic conditions such as diabetes and hypertension, reducing stress through relaxation techniques, and being aware of the signs and symptoms of preterm labour so that medical intervention can be sought promptly. In some cases, medications such as progesterone or cervical cerclage may also be recommended to help prevent preterm labour.
Gestational diabetes:
Multiple pregnancies increase the risk of gestational diabetes, a condition where the mother's blood sugar levels become elevated during pregnancy. This can lead to complications such as preterm labour, preeclampsia, and macrosomia (a large baby).
Preeclampsia:
This is a condition that can occur in pregnancy that is characterised by high blood pressure and damage to organs such as the liver and kidneys. Multiple pregnancies increase the risk of preeclampsia, which can lead to preterm birth and other complications for both mother and babies.
Foetal growth problems:
Multiple pregnancies are at higher risk of fetal growth problems, such as intrauterine growth restriction (IUGR), due to limitations in the uterus and placenta. It can lead to complications during delivery.
Placenta problems:
Placenta problems are also more common in multiple pregnancies, particularly in monochorionic twins who share a placenta, and can lead to foetal growth restriction and other complications.
Twin-to-twin transfusion syndrome (TTTS):
This occurs when blood flows unequally between two foetuses sharing one placenta, and can result in one twin receiving too little blood and the other too much. TTTS happens when blood vessels within the shared placenta connect improperly, causing an uneven blood flow between the foetuses. One twin, called the recipient twin, gets too much blood and can develop heart failure, while the other twin, called the donor twin, gets too little blood and may have organ failure. If left untreated, TTTS can have serious consequences for both twins. However, with early diagnosis and treatment, the chances of a successful outcome are high.
Cord entanglement:
Twins and triplets can become tangled in their umbilical cords, which can lead to reduced blood flow and other complications. Cord entanglement can be diagnosed through ultrasound, and depending on the severity and gestational age of the foetuses, delivery may be recommended to prevent further harm.
If you’re expecting multiples, your doctor would probably already be monitoring your pregnancy closely. Despite the fact that multiple pregnancies face higher risks, with the right care and attention, many twins and triplets in Singapore grow up to be healthy babies. All the best, multiple mama!
Read also: Physical Toll of a Multiple Pregnancy
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