Twin Pregnancy – Early Symptoms:

Most women discover that they are pregnant with twins only after an ultrasound scan. But is there a way to find out a twin pregnancy before the scan? We are sure that is the one question most women have in mind. Yes, you can get an idea even before you make a trip the doctor!

A Very Positive Pregnancy Test:

That sounds a little confusing, doesn’t it? Well, for most women, a pregnancy test taken on the day of missed period often yields a faint line. But if you are carrying twins, it is likely that your test line will come out dark. Why is that? Well, home pregnancy tests look for the presence of the hormone hCG (human chorionic gonadotropin) in the body to confirm a pregnancy. When you are pregnant with twins, your body will produce more hCG and lead to a darker line!

Blood Test:

All bodies are different, so it is possible that your home pregnancy test fails to detect the extra hCG floating around in your body. But a blood test will surely catch it! If you are carrying twins, your blood hCG number is likely to be 30-50% higher than if you were pregnant with a singleton.

Extreme Morning Sickness:

 Many women suffer from morning sickness during their pregnancy. Unlike its name, morning sickness can strike any time of the day. Nausea and vomiting associated with pregnancy are the most visible early pregnancy symptoms. Morning sickness is a direct result of the presence of hCG in the body. It is why women carrying twins tend to have a worse case of this common pregnancy symptom. Intolerance to certain foods, smells, textures are all part of the pregnancy journey but with twins, you’ll get more than you expect. So, if you find yourself heaving after each meal, and rushing to the bathroom to throw up, maybe, just maybe, you are pregnant with twins!Thankfully, you can reduce the discomfort through some simple measures:
  • Avoid food that makes you gag
  • Try smaller, more frequent meals
  • Sip on ginger ale
  • Drink more water
  • Try medication (but only after you discuss it with your doctor)

Elevated HcG Levels :

For various reasons, doctors may monitor HcG (human chorionic gonadotropin) levels. HcG is a hormone detectable in pregnant women’s blood or urine about 10 days post-conception; it increases at a rapid rate, peaking about 10 weeks into the pregnancy. Twins may produce an elevated level of HcG. However, the standard HcG level for twins also falls within the normal range for singletons.

Early/Frequent Fetal Movement :

Feeling a baby — or babies — move inside the womb is one of the most thrilling aspects of pregnancy. Although many moms of multiples do experience more frequent or earlier fetal movement, there is considerable disagreement among medical professionals on the subject. For some women, recognizable feelings of movement occur earlier in subsequent pregnancies, whether there is one baby or more.

Extreme Fatigue

This is the most commonly reported complaint during pregnancy with multiples. Sleepiness, lethargy, and exhaustion during the first trimester can be enhanced because the body is working overtime to nurture more than one baby. In some cases, the fatigue can be attributed to other factors (work, stress, poor nutrition, having other children), but it can also indicate multiples.

Symptoms of twin pregnancy

  • Some women will “just know” they are pregnant with twins. This may be before they have even had confirmation that they are pregnant. They may dream, sense or have a vision or inherent belief that they are pregnant with twins.
  • Some women will be told they are pregnant with twins by their partner, relatives, family or very close friend. Although there is often no evidence to support this claim, when their twin pregnancy is confirmed it really comes as no surprise.
  • Feeling very nauseous from early in the pregnancy. This is sometimes so extreme that the mother finds it difficult to tolerate anything but the blandest, easiest to digest foods.
  • Extreme intolerance to foods, smells, textures and appearance of some foods. Commonly meat, seafood, coffee and tea are the first substances to be found repugnant.
  • The uterus is “large for dates” which reflects the fact that two embryos, rather than one is present.
  • Extreme breast tenderness – to the point where it may be too uncomfortable to wear a bra. Some women find they need to wear crop tops or bandeau style tops as an alternative until their breasts become more comfortable.
  • Wanting and needing to pass urine much more frequently. Although urinary urgency is a common early pregnancy symptom, when pregnant with twins, this is much more magnified.
  • Utter exhaustion and a feeling of being unable to get through each day. This again, is a common pregnancy symptom but is exacerbated during a twin pregnancy.
  • Higher levels of hCG. This may be reflected in a very early pregnancy urine test. Even before a missed period, the level can be so high that there is an immediate, strong and clear positive confirmation on the pregnancy testing stick. For women who have undergone fertility assistance, blood tests may reflect a very high concentration of hCG early after conception.
  • Some women will experience more uterine cramping which is not associated with any blood loss. This can be a symptom of round ligament pain and is due to the uterus expanding relatively quickly.
  • A sense that your heart has to work harder than it usually does. Many women are aware that their resting heart/pulse rate is higher than normal. This is a sign of their heart having to pump out a greater blood volume with each heart muscle contraction in order to supply the uterus with oxygen saturated blood.
  • Moodiness, being prone to tears and feeling mentally unstable. Again, labile moods are a common pregnancy symptom, but when pregnant with twins, they tend to be more extreme.
  • You may find you can feel your baby/babies moving much earlier in your pregnancy. Women who are pregnant with twins say that they are conscious of feeling movements, known as quickening, earlier than the standard 15-16 weeks.

How is a twin pregnancy confirmed?

Although you, your partner or your health care practitioner may suspect you are pregnant with twins, it is not until twins are confirmed that you can be 100% sure.

  • Ultrasound, where two embryos are clearly defined on the screen.
  • Hearing two, separate heartbeats on a Doppler.
  • In the absence of sound ante-natal care, it is still possible that a twin pregnancy may not be evident until two babies are born.

Complications of a twin pregnancy

Unfortunately, the overall risks of pregnancy are increased during a twin pregnancy. But many women have an uneventful gestation and just because you are pregnant with twins, is not a guarantee you will have complications. But it does help to be informed and keep an open mind.

  • Premature birth – e.g. before 38 weeks of gestation.
  • Smaller babies with lower birth weight – simply because there have been two growing in the same space.
  • One baby which is smaller than the other. It is common during twin pregnancy for one twin to receive more nutrition and space allocation than the other.
  • Preeclampsia. This is why it is so important for you to have your BP monitored during your pregnancy. Fluid retention and passing protein in urine are other signs of preeclampsia.
  • Gestational diabetes.

What’s important to remember if pregnant with twins

  • Regular ante natal care with a qualified health care practitioner is essential.
  • It may be worthwhile seeing an accredited practicing dietician to receive evidence based information on diet and meeting your body’s nutritional demands. Check Dieticians Association of Australia
  • Allow yourself plenty of opportunity to rest. Growing twins and supporting them towards maturity takes a lot of energy. You may need to consider your work/leave entitlements and arranging regular home support and child care for older children.
  • You may need to have more regular ultrasounds than if you were carrying one baby.
  • Your healthcare rebate and entitlements may be affected; find out early in your pregnancy what you are covered for, or consider accessing the public health system. Premature baby care can be extremely expensive. Find out your status and coverage early in your pregnancy to avoid unwanted and avoidable expenditures.
  • Plan for and earlier than expected delivery. Twins have a habit of coming early and it pays to be well organised.
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