Multiple Pregnancy

Topics: Pregnancy, Obstetrics, Childbirth Pages: 6 (1218 words) Published: June 30, 2013
Multiple Pregnancies

Definition
Multiple pregnancies are a pregnancy where more than one fetus develops simultaneously in the womb. A multiple pregnancy is a pregnancy involving more than one fetus. Twins, triplets, and quadruplets are multiple pregnancies. The largest multiple pregnancy on recorded to the birth of nine offspring.

Twins are the most common type of multiple pregnancies. But worldwide, the incidence of multiple pregnancies of all types - twins, triplets, quadruplets, quinteplets, sextets, and more - is increasing as advanced types of infertility treatment become more common.

Multiple pregnancies are a pregnancy with two or more fetuses. Names for these include the following: • Twins - 2 fetuses
• Triplets - 3 fetuses
• Quadruplets - 4 fetuses
• Quintuplets - 5 fetuses
• Sextuplets - 6 fetuses
• Septuplets - 7 fetuses
Causes of multiple pregnancies
There are many factors related to having a multiple pregnancy. Naturally occurring factors include the following: • Heredity
A family history of multiple pregnancy increases the chances of having twins.

• Old age
Women age 30- 35 have a greater chance of multiple conceptions.

• High parity having one or more previous pregnancies and delivered ,

• Race: African-American women are more likely to have twins than any other race. Asian and Native Americans have the lowest twinning rates.) Other factors that have greatly increased the multiple birth rates in recent years include reproductive technologies, including the following: • Ovulation-stimulating medications such as clomiphene citrate and follicle stimulating hormone (FSH) help produce many eggs, which, if fertilized, can result in multiple babies.

• Assisted reproductive technologies such as in-vitro fertilization (IVF) and other techniques help couples conceive. These technologies often use ovulation-stimulating medications to produce multiple eggs which are then fertilized. Types of twins:

1) Uniovular twins (Monozygotic, identical) Uniovular twins result from a single fertilized egg that, sometime during the first week following conception, divides into 2 embryonic discs, which develop into 2 separate embryos. Monozygotic twins are genetically identical, similar in physical appearance, and the same sex.

[pic]Monozygotic ("identical") twins[pic][pic] 2) Binovular twins (Dizygotic, fraternal) Binovular twins result from fertilization of two ova, mostly likely ruptured from two distinct graafian follicle usually of the same or one from each ovary by two sperm during a single ovarian cycle. Dizygotic twins look as different as siblings born at different times would look, and can be either the same or different sex. Most twins, about two-thirds, are dizygotic, the other one-third monozygotic.

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Diagnosis of twins pregnancy

• History

• Symptoms:-
- 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 at same time • Abdominal examination
-Inspection: The abdomen is unduly enlarged, and shape like a barrel. - Palpation : The height of the uterus is more than period of amenorrhea, the girth of the abdomen at the level of umbilicus is more than the normal average at term, Palpation of too many fetal parts and finding of two fetal head. -Auscultation:-Simultaneously hearing of two distinct fetal heart sounds located at separate spots. -Internal examination:-In some cases, one head is felt deep in pelvis, while the other one is located by abdominal examination. Investigation:-

• Biochemical tests:-
- Levels of human chorionic gonadotrophin...
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