During labour: Complications of malpresentations: In 45% of cases both twins present by head. In 35% one foetus presents by the head and the other by the breech. In 10% both present by breech. [gfmer.ch]

Cesarean delivery is recommended for twins unless the presenting twin is in vertex presentation. Higher-order multiples are typically delivered by cesarean regardless of presentation. [msdmanuals.com]

Author information 1 Department of Health Science, Ishikawa Prefectural Nursing University, 1-1, Gakuendai, Kahoku 929-1210, Japan. [email protected] Abstract The purpose of the present study was to examine the effect of single embryo transfer [ncbi.nlm.nih.gov]

Vaginal Delivery of the Second Twin •As soon as the presenting twin has been delivered, the presenting part of the second twin, its size, and its relationship to the birth canal should be quickly and carefully ascertained by combined abdominal, vaginal [slideshare.net]

• Weight Gain

  Symptoms of a multiple pregnancy include Weight gain The extra weight is due not only to the babies' combined weights but also the extra tissue, fluid and blood volume you are producing to support two babies. [kidspot.com.au]

  Weight Gain There are numerous factors that can cause excessive weight gain, most of which are attributed to poor eating habits. The amount of weight a woman should gain depends on her height, body type, and pre-pregnancy weight. [americanpregnancy.org]

  Excess Weight Gain You could be carrying twins if you not overeating but you are gaining weight quickly in the early first trimester, and you put on more than the one to two pounds weight gain recommended for all the first trimester. [pregnancy.lovetoknow.com]

  Weight Gain Image Source/Getty Images While mothers of twins only gain about 10 pounds more than singleton mothers, the amount of weight a woman gains often depends more on her height, body type, and how much she weighed pre-pregnancy than the number [multiples.about.com]

• Anemia

  Fifty percent had no antenatal complications, gestational diabetes complicated 16%, and anemia was reported in 22% of cases. CONCLUSION: Preterm delivery remains the most serious complication of multiple pregnancies. [ncbi.nlm.nih.gov]

  Twin-to-twin transfusion syndrome is associated with various risks, including anemia and growth retardation in the donor twin, and polycythemia in the recipient twin. [amboss.com]

  However, prior anemia, poor diet, and malabsorption may precede or compound iron deficiency during multiple pregnancy. [health.am]

  Anemia Anemia is more than twice as common in multiple pregnancies as in a single birth. [urmc.rochester.edu]

• Fatigue

  Severe Fatigue JGI/Tom Grill/Getty Images Extreme fatigue is the most commonly reported complaint during pregnancy with multiples. [multiples.about.com]

  Extreme fatigue While all women experience overwhelming fatigue in their first trimester of pregnancy, women carrying twins report a tiredness that never lifts and can't be ignored. [kidspot.com.au]

  Fatigue: Excessive fatigue is one of the most commonly reported complaints of mothers of multiples in the early stages of pregnancy. [familyeducation.com]

  Extreme Fatigue If you notice you have extreme fatigue during your pregnancy, it is possible you are pregnant with twins. [pregnancy.lovetoknow.com]

• Severe Pain

  The symptoms of such a tubal rupture are vaginal bleeding and severe pain in one side of the abdomen. Prompt surgery is necessary to remove the damaged tube and the fetus, and to stop the bleeding. [medical-dictionary.thefreedictionary.com]

• Asymptomatic

  Beta-mimetic treatment is indicated in multiple pregnancies even in false labor, or when painless progress in cervical dilatation is observed, to avoid asymptomatic progression into true labor. [ncbi.nlm.nih.gov]

• Respiratory Distress

  distress syndrome (average RR 1.70, 95% CI 0.15 to 18.77, three trials, n = 116). [ncbi.nlm.nih.gov]

  Babies at are greater risk for respiratory distress after birth, diabetes, obesity and developmental problems later in life. Women with gestational diabetes are also more prone to diabetes after pregnancy. [ivf1.com]

  Página 526 - Association between maternal diabetes and the respiratory distress syndrome in the newborn - Robert MF, Neff RK ‎ [books.google.es]

• Nausea

  Nausea: Extra babies can intensify the symptoms of morning sickness, such as nausea and vomiting. You may be aware of some or all of these indications, or none at all. [familyeducation.com]

  While some women experience more severe nausea and vomiting while carrying twins, intense morning sickness can also occur when pregnant with a single baby. [livestrong.com]

  Overall, about half of women experience some amount of nausea and vomiting with single pregnancies, and up to 1 percent experience hyperemesis gravidarum, a form of severe morning sickness. [multiples.about.com]

  And while most women pregnant with twins or more, will experience the same pregnancy symptoms as those pregnant with a singleton, they do often experience heightened pregnancy symptoms - severe nausea, extreme fatigue and fast weight gain - that may indicate [kidspot.com.au]

  My own experience was 24-hour extreme nausea for a little past the first trimester. At 14 weeks, the morning sickness miraculously disappeared, and was I ever thankful! 2. [tummywear.org]

• Morning Sickness

  Excessive Morning Sickness About half of all pregnant women experience some form of morning sickness during pregnancy. While some mothers of multiples report an increase in the severity of morning sickness, many do not. [americanpregnancy.org]

  Statistically, moms of multiples may experience more morning sickness, but using the degree of morning sickness as an estimate that you are carrying twins isn't necessarily very helpful. [multiples.about.com]

  Common pregnancy health worries with twins It's not necessarily true that you will have more morning sickness if you’re expecting twins. Although some women expecting twins or more report lots of morning sickness, others don't experience any. [nhs.uk]

  Severe morning sickness symptoms Almost all women carrying multiples report suffering from morning sickness and their symptoms tend to be more severe than their pregnant-with-one counterparts. [kidspot.com.au]

• Vomiting

  You might suspect you are pregnant with multiples if you have more severe body changes, including: Rapid weight gain in the first trimester Intense nausea and vomiting Extreme breast tenderness Your doctor can confirm whether you are carrying more than [womenshealth.gov]

  While some women experience more severe nausea and vomiting while carrying twins, intense morning sickness can also occur when pregnant with a single baby. [livestrong.com]

  Nausea: Extra babies can intensify the symptoms of morning sickness, such as nausea and vomiting. You may be aware of some or all of these indications, or none at all. [familyeducation.com]

  Morning sickness is nausea (feeling sick to your stomach) and vomiting that happens in the first few months of pregnancy, usually in the first few months. It’s sometimes called nausea and vomiting of pregnancy or NVP. [marchofdimes.org]

• Constipation

  These will help you avoid constipation and provide a range of vitamins and minerals. You also need some protein foods, such as lean red meat, well-cooked eggs, and nuts and seeds. [nhs.uk]

  Annoying issues such as morning sickness, weight gain, heartburn, constipation, shortness of breath (especially on any type of exertion), urinary problems, and hemorrhoids are all likely to be magnified. [dummies.com]

  Cause constipation, often made worse if you have to take iron tablets for anaemia (McAslan Fraser 2012). You'll also feel the physical demands of carrying two babies. [babycentre.co.uk]

  Constipation usually can be corrected by diet or a mild laxative; strong laxatives should not be used unless prescribed by the health care provider. [medical-dictionary.thefreedictionary.com]

• Increased Appetite

  Symptoms of multiple pregnancy may include: uterus is larger than expected for the dates in pregnancy increased morning sickness increased appetite excessive weight gain, especially in early pregnancy fetal movements felt in different parts of abdomen [chw.org]

  When you are carrying two babies, you develop an increased appetite as your body demands more food for the growing babies. Twin pregnant belly is obvious as the bump is bigger than normal. [momjunction.com]

• Back Pain

  Signs of Preterm Labor: Diarrhea Low back pain Abdominal cramps Pelvic pressure An 'intuitive' feeling that something's not right. [twinslist.org]

  Frequent back pains are a result of excess weight gain, uterus enlargement, and excess hormonal activity. Standing straight and holding your chest high can help you relax. Make sure to wear flats and avoid locking your knees while sitting. [momjunction.com]

  If you experience back or hip pain as your pregnancy progresses, ask your midwife to refer you to a women's health physiotherapist (NCCWCH 2011). [babycentre.co.uk]

• Low Back Pain

  Signs of Preterm Labor: Diarrhea Low back pain Abdominal cramps Pelvic pressure An 'intuitive' feeling that something's not right. [twinslist.org]

• Forgetful

  Heck, you can even get books about twins written just for Dads, so don't forget him! Do not, however, buy a book about general pregnancy. You have to remember that your situation is unique and will require special care. [twin-pregnancy-and-beyond.com]

  Don’t forget, the stronger you are, the easier it will be on your body to carry the extra weight of a multiples pregnancy. – Anticipate upcoming growth. [knocked-upfitness.com]

  Dealing with Grief - Sometimes grieving parents forget the obvious such as eating well and generally looking after themselves while grieving. [multiplebirthscanada.org]

• Lethargy

  Sleepiness, lethargy, and exhaustion during the first trimester can be enhanced because the body is working overtime to nurture more than one baby. [multiples.about.com]

  Most pregnant women face some degree of sleepiness, lethargy and exhaustion during the first trimester as the body gears up and works overtime to nurture your growing baby. [tummywear.org]

  Twin pregnancy translates into fatigue, exhaustion, sleepiness, and lethargy, two to three weeks into pregnancy. As you have to nurture two babies, you need good sleep and sufficient food for your body to work properly. [momjunction.com]

• Pelvic Pain

  You may also find you have backache and pelvic pain, particularly later in your pregnancy. Speak to your midwife, who may refer you to an obstetric physiotherapist. [nhs.uk]

A significant concern exists about these treatments, however, because of the risk of MGP. [academic.oup.com]

The challenge is to reduce multigestational pregnancies while maintaining good treatment outcomes. [ncbi.nlm.nih.gov]

CONCLUSION: Selective SBT in women with good prognosis can reduce the MPR after IVF while maintaining the overall success rate of the IVF programme. [ncbi.nlm.nih.gov]

Acute unbalancement can also occur at any time before birth, threatening the prognosis [ 76 ]. [intechopen.com]

Prognosis The U.S. maternal mortality rate for multiple pregnancy is only slightly higher than for singleton. A history of previous dizygotic twins increases the likelihood of subsequent multiple pregnancy 10-fold. [health.am]

These increased costs are due to the need for more intensive monitoring of these infants and the complex medical and surgical procedures that are increasingly being performed in order to decrease mortality and improve their prognosis. [ispub.com]

The register is an important resource of data on multiple pregnancies, which allows monitoring of trends in multiple birth rates and pregnancy losses and provides a unique opportunity for etiological and long-term follow-up studies. [ncbi.nlm.nih.gov]

Etiology Classification Special features in the development of monozygotic twins A dizygotic pregnancy results in a dichorionic-diamniotic pregnancy. [amboss.com]

Internal teratoma Internal teratomas are rare congenital tumors, usually benign and of multifactorial etiology. [intechopen.com]

Epidemiology References: [1] Epidemiological data refers to the US, unless otherwise specified. Etiology Classification Special features in the development of monozygotic twins A dizygotic pregnancy results in a dichorionic-diamniotic pregnancy. [amboss.com]

This population-based survey is an important source of data on multiple pregnancies, which allows monitoring of trends in multiple birth rates and pregnancy losses, providing essential information to support improvements in clinical care and for epidemiological [ncbi.nlm.nih.gov]

Epidemiology Currently in America, approximately 1 in every 250 births is a multiple: twins, triplets, or higher-order multiples. [pedsinreview.aappublications.org]

Epidemiology The incidence of twins is 3 in 200 pregnancies; triplets 1 in 10,000 pregnancies. The incidence is increasing alongside the increased uptake of IVF therapy. [fastbleep.com]

According to the textbook, Multiple Pregnancy: Epidemiology, Gestation and Perinatal Outcome, (page 300), women carrying twins have a more rapid and excess weight gain early in pregnancy than women pregnant with one baby. [pregnancy.lovetoknow.com]

Recently, immune pathways have been implicated in the pathophysiology of RSA. Immune tolerance of the fetal-placental unit and placental angiogenesis are mandatory for a successful pregnancy outcome. [ncbi.nlm.nih.gov]

It emphasizes important new concepts of pathophysiology and interpretation of less than ideal outcomes of multiple conception based on over 30 years experience in the field. [springer.com]

Pathophysiology: • Presence of solitary, deep arteriovenous channels within the capillary beds of the villous tissue. • Velamentous umbilical cord insertion may contribute to the development of unequal fetal blood volumes because the membranously inserted [slideshare.net]

Effective strategies must be established to prevent multiple pregnancy without reducing overall pregnancy rates. [ncbi.nlm.nih.gov]