Surveillance And Monitoring Of Twin Pregnancies

Twin pregnancy requires more care than pregnancy with a single fetus because of the increased potential for problems such as twin-twin transfusion syndrome, selective fetal development restriction, and premature delivery. Surveillance and monitoring of twin pregnancy, diagnosing, and directing therapy of these possible problems may be greatly aided by ultrasound, which is both non-invasive and effective. Varied kinds of twin pregnancies need different ultrasound monitoring schedules.

Different combinations of identical and fraternal twins

The medical community recognises three distinct sets of twins. Even though a pregnancy with triplets will be more complicated than one with twins, these guidelines still apply. Those three categories are as follows:

• Twins that share a sac but not a placenta are said to be dichorionic diamniotic (DCDA).
• MCDA twins, or monochorionic diamniotic twins, are identical in all ways except that they each have their sac rather than a shared placenta.
• Monochorionic monoamniotic (MCMA) twins are very unusual since they share a placenta and a sac.

All siblings that aren't identical to each other have DCDA. Most sets of twins have the same MCDA and DCDA genotypes, but there will always be an exception. For example, conjoined twins that are MCMA are very unusual.

Surveillance and monitoring of twin pregnancies

All pregnancies with multiple embryos have a higher risk of miscarriage, early birth, and stillbirth, as well as an increased risk of maternal complications such as anaemia, high blood pressure, and severe bleeding after delivery.

Based on the number of placentas present during pregnancy, identical twins are categorized as either single placenta twins or double placenta twins. Important distinction: single placenta twins are subject to further observation. Pregnancies with double placenta twins often progress without incident and need monitoring every four weeks.

However, there is a 15% probability of special complications such as selective foetal development restriction, twin-to-twin transfusion syndrome, and twin anaemia polycythemia sequence in single placenta twins. When two embryos share a single placenta, it causes new complications.

The best possible result may be achieved with timely intervention, which is why early detection of such issues is crucial. Every two weeks, doctors check in on a set of monochorionic twins to carefully inspect them for growth, fluid, and Doppler differences. Every four weeks, dichorionic twins are checked for abnormal development.

It's vital to remember that Surveillance and monitoring of twin pregnancies performed in the first trimester of pregnancy are more reliable than those performed later in the pregnancy for classifying twin pregnancies as monochorionic or dichorionic. Consequently, you should see your doctor if the FTS scan results do not definitively classify your twin pregnancy as a monochorionic or dichorionic pregnancy.

Dietary requirements for women expecting twins

A woman bearing twins has unusual dietary requirements, including increased caloric intake. It is suggested that the patient see a nutritionist to address this and other concerns, including the common occurrence of early satiety and lack of appetite.

• Approximately 600 more calories per day, or about 300 more than a woman carrying a singleton, must be added to her diet.
• Women expecting twins should take at least 30 milligrams of iron in the first trimester and 60 milligrams of iron up until birth to reduce their risk of anaemia. Additionally, 1 mg of folic acid daily is suggested to reduce the risk of neural tube abnormalities.
• Given their beneficial nutritional profile, high-protein shakes are highly recommended.

Dangers involved with carrying twins

While most pregnancies end in healthy children, expecting mothers of twins or more should take extra precautions. Multiple pregnancies increase a woman's chance of developing serious health problems during and after the pregnancy, including anaemia from a lack of iron and preeclampsia.

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