The Effect of Twins on Pregnancy

The Effect of Twins on Pregnancy

Pre-eclampsia is more common than in single pregnancies.Polyhydramnios. Acute polyhydramnios is invariably associatedwith uniovular twins ,the usual outcome being abortion.

Anaemia develops because of the increased fetal demands foriron:

The minor disorders and general discomforts of pregnancy aremore pronounced: morning sickness, nausea and heartburn are more persistent.

Pressure symptoms due to the weight and size of the uterus maybe troublesome,

·              The tendency to oedema of the ankles and varicose veins is increased because of pressure on the veins returning blood from the lower limbs,

·              Dyspnoea and indigestion are more marked: backache is common.

Management of Pregnancy

As soon as twins are diagnosed a close check should be kept on the mother's haemoglobin and advice given regarding foods rich in iron.

Ferrous preparations are usually prescribed and vitamin supplements are essential.. The woman should drink at least 1200 ml of milk daily to prevent her calcium reserves from being depleted.

Her protein intake must be adequate.

In order to detect pre-eclampsia which is three times more common in multiple pregnancy, the woman is seen weekly from the time twins are diagnosed about the 20th week.

To relieve the discomfort of a heavy uterus, a good supporting maternity belt will be appreciated.

Extra pillows are needed for sleep, as the woman feels more comfortable when propped up. Adequate rest is essential during the last 12 weeks to increase uterine blood flow.

The woman may be admitted to hospital from the 30th to the 36th week to avoid preterm labour by providing rest, and to improve her nutrition. She should not be permitted to go beyond term but many go into labour prior to then.