Twin Pregnancy Complications For Babies Problems For Babies In Twin Pregnancy Risk Factors For Twins

Risks and complications: babies

Many of the serious complications of twin pregnancies have little to do with behaviour or lifestyle but it goes without saying that the mum-to-be has to ensure that she lives a healthy lifestyle to give her baby the best possible start - no smoking, alcohol or drugs, a good diet and plenty of rest. This is especially true for mums carrying twins.

One of the most important aspects is getting an early confirmation that you are carrying twins and then to find out what type of twins you are having (identical / fraternal). This will allow your midwife / doctor to monitor you and your babies carefully and catch and treat any complications that may crop up as soon as possible.

There are less complications in twin pregnancies if your babies have separate amniotic sacs, or are fraternal twins formed from separate eggs (each with their own membrane and amniotic sac). The risks to their health in the womb are higher for identical twins, particularly those that share a chorion.

Vanishing Twin Syndrome

One slight drawback of a very early diagnosis however is "Vanishing Twin Syndrome". Early ultrasounds that indicate twins can lead to disappointment as you'll have no sooner got over the news and adapted to the idea of two babies when a subsequent scan reveals only one baby. The second sac has simply vanished - either having been reabsorbed or miscarried.

Just as with single pregnancies, after 12 weeks the risks of losing the baby / babies reduces, and a scan at this stage will show whether you really are having twins or not. It is likely that many single pregnancies started out as twin pregnancies with the second sac having vanished even before the first ultrasound, leaving mum-to-be none the wiser.

Twin-to-twin transfusion syndrome

Twin-to-twin transfusion syndrome, when one twin shares the other's blood supply, is a rare but potentially serious complication in identical twins that share the outer membrane and one amniotic sac.

One baby gets too much blood and the other gets too little. Until recently, severe cases meant the death of both babies but advances in early detection and treatment mean that survival rates are now much higher.

Placental abruption (placenta abruptio)

Placental abruption is the separation of the placenta (the organ that nourishes the foetus) from its attachment to the wall of the uterus before the baby is delivered. It is a potentially serious condition and is more common when you're carrying more than one baby.

Causes include trauma to the belly (fall, punch, accident) but it can also occur when there is a sudden loss of uterine volume which can occur with rapid loss of amniotic fluid or after a first twin is delivered.

Symptoms include abdominal pain, back pain, frequent or constant uterine contractions and vaginal bleeding.

Placental abruption, which includes any amount of placental separation before delivery, occurs in about 1 out of 120 twin deliveries (1 out of 150 single pregnancies). The severe form, which can cause the baby to die, occurs in about 1 out of 500 of twin deliveries.

Foetal growth restriction

Foetal growth restriction can cause complications during labour and birth. Twins grow at approximately the same rate as a single pregnancy up to a certain point - the growth rate of twin pregnancies begins to slow at 30 to 32 weeks because the placenta cannot handle any more growth and because the babies are competing for nutrients and uterine space. Many twins are born small but perfectly healthy and frequent scanning to monitor your twins' growth can detect any problems.

Preterm labour /delivery

Preterm labour /delivery is defined as delivery before 37 completed weeks of pregnancy. Almost 60% of twins are delivered preterm. The risk of developing health problems increases with the degree of prematurity — babies born closer to their due date have a lower risk.

Preterm deliveries are more common among women younger than 19 or older than 40, and among those with a previous preterm delivery.

The more premature the baby, the greater their special needs and they often begin their lives after delivery in a neonatal intensive care unit (NICU).

Intrauterine demise

Although extremely uncommon, very sadly, one of the babies can die in the womb later on in pregnancy.

In an identical twin situation where the babies share a chorion (the membrane that forms the foetal portion of the placenta) there is an increased chance that the surviving twin will either also die or be negatively affected. When twin-to-twin transfusion is present almost half of the other babies will also die or be affected by their twins demise.

In non identical twins or twins with two chorions, then intervention may not be necessary. Foetal maturity will be assessed to see if immediate delivery is possible with the risks between having a premature baby to the risks of remaining in utero being carefully weighed up.

Antenatal care in twin pregnancy
Complications of twin pregnancies for babies
Complications of twin pregnancies for mums