Signs of Multiple Pregnancy: Nuances and Hidden Rocks

Multiple pregnancy. a man hugging pregnant woman

Multiple Pregnancy – when does a woman receive such a conclusion of specialists? And can expectant mother determine that she awaits several kids at once, even before the visit to the women’s consultation? We will answer these questions, considering a number of multiple pregnancy signs: including the ones that women share with each other.

Signs of Multiple Pregnancy: Questionable, Probable and Reliable

So, the woman knows for sure she is pregnant. The next natural desire of the expectant mother becomes the desire to quickly find out who is it going to be — a girl, a boy, or if there are determinants (heredity, IVF, pregnancy after 35 years old etc.) several children?

There are signs that allow determining multiple pregnancies, which can be divided into several groups. Let’s highlight questionable, probable and reliable ones.

Questionable signs are those that are based solely on subjective feelings of a woman (special changes in health, physical parameters, habits). It means that such signs indeed may occur — they are not deceptive, however they are not a guaranteed proof of multiple pregnancy either. Yes, some were observed to have these signs and these signs perfectly “worked” as a prediction for the birth of twins. But this is not always the case. Someone had questionable signs, but medical diagnosis refuted the assumption of multiple pregnancy. And someone didn’t have any of these signs at all.

multiple pregnancy. question marks on a pregnant belly

Probable signs. They are more often determined by the doctor during the examination of the woman. But since such signs have not yet been confirmed by the diagnosis, it is too early to make a final conclusion about multiple pregnancies.

Reliable signs are signs that are confirmed by the diagnosis and clearly indicate multiple pregnancies.

And now about all the signs in order and in detail.

Signs of Multiple Pregnancy in Early Stages

These features include questionable and probable signs. They are based only on subjective feelings of a woman and primary examinations by a doctor without diagnosis.

Questionable Signs of Multiple Pregnancy

Weight gain

Often, in anticipation of twins, women really gain a little more weight than expectant mothers of one child. On average, we are talking about 2-5 kilograms “from above” physiologically justified weight gain. But let us not forget that these kilograms are not gained in the first weeks after conception, and distributed for the entire period of carrying. So if, getting pregnant, a woman soon notes a significant change in numbers on her bathroom scales — it does not always indicate that she is carrying several babies.

Weight gain is sometimes provoked by other factors. For example, a dramatic change in lifestyle. When, learning about her situation, a woman instinctively reduces physical activity (in fact, this is not quite true, healthy activity of a pregnant woman is necessary), sleep more and rest, tries to eat “for two”… And, as a result, somewhat overdo in the good undertakings that invariably reflects on weight.

Unfortunately, there is a much more serious reason for a sudden change in size. So, obviously, a rapid weight gain in the first trimester can be one of the symptoms of gestational diabetes mellitus. And here we really need an urgent consultation of the gynecologist-endocrinologist.

multiple pregnancy. a woman on the scales

Rapid growth of belly

Yes, as a rule, when carrying twins, the belly is rounded already in the first trimester, because the uterus increases several weeks earlier than when pregnant with one baby. But it can not be argued that the process of abdominal growth of all expectant mothers goes the same. Someone observes pleasant roundness already by week 12, and some do not notice special changes in their parameters up to week 20.

Moreover, even if the belly grows quickly enough, in addition to multiple pregnancy, it can indicate the swelling of the intestinal loops, a large number of amniotic waters, and initially incorrect estimation of pregnancy period.

Increased fatigue and drowsiness

Many pregnant women note that they quickly get tired and often have an irresistible desire to take a nap in the morning. Do these sensations increase in multiple pregnancies? Carrying several babies at the same time is a considerable load on the woman’s body. And therefore, indeed, sometimes the expectant mother of twins feels tired literally in the morning. But again, it is impossible to say that the constant desire to sleep is an exceptional evidence of multiple pregnancies.

First, there is no scale or standards of fatigue, from which one could argue that, right now, fatigue is high and drowsiness is excessive. All this is a very subjective feeling. And secondly, there are more than enough reasons to get tired or want to sleep when it comes to a modern woman – work, household chores, shopping. Today you are tired a little less, tomorrow, with the same schedule – a little more. Chronic fatigue, stress, poor nutrition, overly active or, on the contrary, passive lifestyle – all these are quite real sources of desire to lie down to rest.

multiple pregnancy. a sleeping pregnant woman

Strong morning sickness

Indeed, in some cases of multiple pregnancies, toxicosis is more pronounced. Most often it is caused by the reaction of the body to an elevated level of hormones – progesterone, HCG. But this is not always the case. Some mothers of twins note that their pregnancy proceeded easily, completely free of toxicosis and nothing special differed in feelings of pregnancy with one child. Whereas in cases of other mothers who have one baby, toxicosis was pronounced and literally exhausting.

Probable Signs of Multiple Pregnancy

High measurement results of the fundal height

Already at the first visit to the consultation for registration of pregnancy, the doctor carries out an examination of the woman, including measures of the fundal height.

To do this, the pregnant woman lies on her back and straightens her legs (an important requirement is the emptied bladder on the eve of the examination), and the gynecologist with the use of usual “centimeter” measures the distance from the upper point of the uterus to the pubis. The figures are compared with the accepted standards by a certain time frame. As a rule, with multiple pregnancies from approximately week 10-11 the uterus is slightly larger, and from week 12-13 on, it can be palpated over the pubic.

Yet there are exceptions to any rule. In some cases, the uterus, in which several embryos develop, does not differ from the uterus in which one embryo develops. And the rapid growth of the organ is observed only from the second trimester. Then the size of the uterus is 2-3 centimeters higher than the indicators in single pregnancies. Moreover, from week 20 to week 28 the difference is already 4-6 centimeters.

multiple pregnancy. fundal height measurment

Are the results of measuring the height of the uterus bottom a good sign of multiple pregnancy? As we can see, not always. But what if the results for this period are still high? Not only could multiple pregnancies affect them. And the multiplicity, and anatomical features of the woman (for example, with a narrow pelvis of the uterus slightly larger), and large size of the fetus.

Results of uterine palpation

Examining a woman, an experienced doctor can determine some depression of the uterine bottom or recess on the anterior wall of the organ. In the first case, the recess is formed by the profilement of the corners of the organ by several fetuses, in the second case, for example, a horizontal recess occurs when the children are transverse. Nonetheless, the doctor can find parts of the body of two or more babies only during late pregnancy.

By the way, for a long time, palping remained the only way to determine multiple pregnancies. Only with the advent and widespread use of modern equipment, such method of examination ceased to be considered the most reliable.

Early and frequent fetal movements

Unless mother, carrying one baby, begins to feel the moves about week 16-22, then twins sometimes “manifest themselves” a little earlier – around week 15-17. Some women note that they felt the first move of children on week 14 and even on week 13. You should understand that in most cases, such sensations have nothing to do with the movements of the fetus. The intestine provides such activity in the abdomen.

At this time, the fetus, no matter one or more, is still very tiny and weighs not more than 200-300 grams. The coming child simply does not have the strength for active kicks. And only closer to the 20th week, all these inner tremblings can be associated with the movements of the babies. Expectant mothers feel slight kicks, tickling, stroking and whipping.

Why did we consider this method to be probable? Recognize how many babies move (one, two or three?) at first very difficult, especially if it is the first pregnancy of a woman and she simply cannot compare her new sensations to anything.

Moreover, even those women who already know for sure they bear twins, do not always note the same activity of their crumbs: some of the babies move more, some – less.

multiple pregnancy. a woman pregnant with two babies

Increased level of chorionic gonadotropin

Analysis for HCG — pregnancy hormone — all expectant mothers pass one way or another. For the first time — making a home pregnancy test. The presence of this hormone in the body (in urine and blood) indicates the onset of pregnancy and is reflected through the second strip on the test. Some pregnant with twins remember that they saw a distinct strip on the test, flashy, bold. Should this always be the case? Not at all. Since, although there are generally accepted norms of HCG in pregnancy, each pregnancy is unique, and the test is primarily intended to reflect the presence of HCG, not its quantity.

Blood analysis for HCG is considered more accurate — it gives a quantitative definition of the hormone. The results obtained in multiple pregnancies are higher than in the pregnancy with one child at the same time. At times.

However, a high level of hormone may mean an error in the calculation of pregnancy dates. Or mother’s diabetes mellitus, gestosis, bladder. There is no need to be scared ahead of time – these are diagnoses, though serious, but are rare. Nonetheless, it is worth reinsurance and seeking advice from a doctor.

Increased result of AFP analysis. Blood test to determine the level of alpha-fetoproteins is recommended for pregnant women to pass from week 12 to 20 to determine the risk of defects in the development of the fetus. The results of this analysis should meet the standards for each given time frame. When pregnant with several babies, the result is always higher than normal.

Reliable Signs of Multiple Pregnancy

Results of phono-and electrocardiography

These studies make it possible to assess the heart activity of the fetus. And, of course, reveal the beating of not one, but several small hearts at once in multiple pregnancy. However, people resort to such procedures, as a rule, only after week 20.

multiple pregnancy. a pregnant woman at the doctor

Ultrasound confirmation

And the study with modern ultrasound devices is able to establish multiple pregnancy already on the 5th week! Thus, during the examination with a vaginal sensor, the specialist sees several ova in the uterus cavity.

A little later, on about week 20, the specialist sees the embryos themselves, determines the type of placenta: children have it either shared or separated.

Note that  when pregnant with twins, ultrasound is recommended to pass more frequently. Two (or three by doctor’s appointment) examinations in the first trimester, after week 14 – every 3 weeks in monochorial pregnancy (each fetus has shared placenta), or after week 20 – every 4 weeks in case of dichorial pregnancy (each fetus has its own placenta). For mothers and babies, this frequency of examinations is not dangerous and allows doctors to accurately observe and evaluate the course of pregnancy.

To date, ultrasound is considered the most reliable way to determine multiple pregnancies. However, this does not mean that the expectant mother should not listen to the signals of her body before passing an ultrasound examination. Have you noticed something unusual? Do not delay writing down your observations and sensations in the diary of pregnancy and do not hesitate to consult your doctor again for clarification.

Stay healthy and easy pregnancy!

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