General

Multiple pregnancy

Multiple pregnancy

The picture revived in the eyes of multiple pregnancy; a twin stroller on the street, a framed photo frame that attracts all the attention and makes everyone smile from the inside. için For mother and father, it is the rightful pride of successfully accomplishing such a challenging task…
"Twins are special, double happiness, a gift given to people throughout history," said Bahçeci Clinic Gynecology and IVF Specialist Op. Dr. Burçak Erzik, oğ Multiple pregnancies are risky pregnancies. We gynecologists, especially we have to follow every stage of pregnancy carefully and guide our parents towards. Today, thanks to modern obstetric and neonatal care conditions, careful monitoring of each baby as a separate individual makes possible healthy pregnancies and healthy babies will be born. Ve

How often do multiple pregnancies occur in the community?

Multiple pregnancies account for 1-2% of all births. Twin births occur every 80 births, triplets every 7500, quadruplets every 650,000. In the last 25 years, there has been an increase of 65% in twin pregnancies and 500% in triplet and over pregnancies. Today, the main target in IVF treatments; The highest rate is to get singular pregnancy in order to have the chance to take the baby home. However, multiple pregnancies are inevitable as they are directly proportional to the number of embryos transferred. The multiple pregnancy rate is 30-35%, of which 85% is twin pregnancies.

How do multiple pregnancies occur?

Monozygotic twins, ie monozygotic twins, occur by dividing the embryo formed by a single egg and a single sperm. It occurs in one third of natural twin pregnancies. Gemini has the same gender and physical characteristics. Some manipulative procedures performed on the embryo in IVF treatments increase the incidence of single twins.

Separate twins, namely dizygotic twins, are formed by fertilizing two separate eggs with two separate sperms. Gemini can have different sexes, their physical characteristics are just as similar as siblings. Dizigotik twins increased by 40% in the population due to in vitro fertilization and ovulation-stimulating treatments. 45% of the twins have male-male, 30% female-female and 25% female-male.

Factors leading to multiple pregnancy?

• In vitro fertilization and ovulation-stimulating treatments
• Advanced maternal age
• Genetic predisposition; the chance of giving birth to twins for a woman born as twins with a recessive character by the mother increases by 10 times.
• As height and weight increase, the frequency of twin pregnancy increases.
• Pregnancies following birth control

How is multiple pregnancy diagnosed?

6-8. We can make the diagnosis of multiple pregnancies by ultrasonographic evaluation in the postnatal week. High levels of beta-HCG in pregnancies caused by in vitro fertilization may point to multiple pregnancies, and it is necessary to wait for ultrasonography control due to both embryonal losses and differences in blood levels in the early period.

When is the ideal birth week?

Mean birth week was 35th in twin pregnancies and 32nd in triplet pregnancies. Minimization of risks in terms of newborns occurs when the 38th gestational week in twins and 35th gestational week in triplets are reached. The mean birth weight was 3350 gr in single newborn, 2400 gr in twins and 1735 gr in triplets. In other words, the target for twins is to keep the total weight at birth between 4500-5000 g and triplets at 5000-5800 g. In twin pregnancies, fetuses exceeding 1500 g and 32nd gestational week are a step that makes us feel comfortable.

What are the risks of newborns in multiple pregnancies?

• Prematurity - 1.5% of singleton pregnancies, 15% of twins and 40% of triplets give birth before 33 weeks of gestation are completed. This increases the need for neonatal intensive care unit 10 times in twins and 26 times in triplets compared to single pregnancies.
• Low birth weight infant - occurs in one quarter of twins and triplets in half.
• Twin-to-twin syndrome - when one of the twins enters the receiving location of the recipient.
• Cerebral palsy - permanent brain injury due to insufficient oxygenation in fetuses

What are the risks awaiting the expectant mother in multiple pregnancies?

• Preterm labor, cervical insufficiency, early arrival of water
• Preeclampsia - association of findings of high blood pressure, edema, kidney problems
• Placental placement problems - one of the babies is in front of the cervical canal
• Placental abruptio - separation of the placenta from the uterus before birth
• Pregnancy-related diabetes
• Anemia, increased urinary tract infections

What can we do to successfully complete our pregnancy?

Our general principle in the follow-up of pregnancy is not to impose restrictions on daily and business life and to experience pregnancy as a natural life process. However, we recommend a limited lifestyle to our twin pregnancies, especially because of early loss and complications due to preterm labor. Of course, this does not mean continuous rest. Unless there is a medical justification, we recommend daily and business life at a lightened pace, half-hour walking and swimming. In this way, pregnant women relax both mentally and physically and excessive weight gain is prevented and sleep order is maintained. 2.5-3 liters of liquid should be consumed daily and increased iron and calcium needs should be supported by natural foods - meat, dairy products, dark green vegetables. Standard vitamin and iron dosages applied to pregnant women are usually sufficient. An extra 300 calories are needed compared to a single pregnant woman (1 extra milk, 3 extra meatballs). Quality nutrition, weight gain between 11-15 kg will help prevent complications such as unwanted preeclampsia and pregnancy diabetes.

What should be the ideal mode of delivery?

In multiple pregnancies of triplets and over, delivery type is undisputed caesarean section. Although there are the authorities who accept that normal birth can be tried safely in case of twin babies as head coming in twin pregnancies, our approach is to perform birth by caesarean section without any risk in these challenging pregnancies which have reached the last and most critical stage.