On Episode Five, we discuss the seven most common complications that can arise in a multiple pregnancy.

Maternal-Fetal Medicine Specialist Associate Professor Craig Pennell explains certain conditions to be aware of, what to look out for, and what do when you receive a diagnosis you’re not expecting.

Author Alexa Bigwarfe talks about twin-to-twin transfusion syndrome, and I share my story of intrauterine growth restriction.

By the end of this episode, you’ll have an in-depth understanding of the many possibilities that could affect your pregnancy, but hopefully, you’ll be reassured that if you’re in the right hands those obstacles can be surmounted and you’ll be able to enjoy your pregnancy.

The risks of having a multiple pregnancy

Once you’ve been diagnosed with a multiple pregnancy, there is so much to learn that falls outside what you might already know about pregnancy. When you’re carrying twins, triplets, or quadruplet babies the risk for complications rises and depending on what type of multiples you have on board will determine the level of that risk, and what treatment options are available to you.

Maternal-Fetal Medicine Specialist Professor Craig Pennell says even though there are increased risks involved with multiple pregnancies that doesn’t mean you can’t enjoy your pregnancy.

“The things that can go wrong in multiple pregnancies are divided into those that can happen to all multiples and those that are specific to particular multiples,”

“For example, Monochorionic Monoamniotic twins, also known as MoMos, account for just one-percent of identical twins and they’re the type of twins where cord entanglement can cause problems, which is associated with a loss rate in the pregnancy of up to 50 percent,”

“In all the other types of twins where there is a membrane between them so those conditions can’t occur,” explains Associate Professor Pennell.

If we look at twins, in general, some of the things that can occur are:

Hyperemesis

Severe nausea and vomiting are very common in a multiple pregnancy, according to Associate Professor Pennell.

Associate Professor Pennell reassures us that the condition usually goes away at the end of the first trimester, so around 13-or-14 weeks, however, in about 10 percent of women it continues throughout the pregnancy.

Miscarriage

According to Associate Professor Pennell, the other thing that is more common in the first trimester of a multiple pregnancy is a miscarriage. He says the rate of miscarriage in twins is at least double, if not higher, than the rate in singletons. And, it’s often not noticed or simply missed depending on when you have your first ultrasound.

“If you’re having scans from five-weeks, you may see what starts as a twin pregnancy that then ends as a singleton somewhere between six-and-12 weeks, whereas if your first scan is at nine-weeks, you may not realise that it started as a twin,”

Not surprisingly, the rate of miscarriage in Higher Order Multiples is again higher. This is somewhere in the order of 30-50 percent where you would lose at least one of the embryos in the first trimester, according to Associate Professor Pennell.

Structural Anomalies

All babies have the chance of having a structural problem (about five-percent), which includes such things as a clubbed foot, an extra finger, cleft-lip-and-palette, a hole in the heart, or an issue with the kidneys.

“With Dichorionic twins, the rate is double that of a singleton,”

“With Monochorionic twins, the rate is even higher than that because Monochorionic twins in itself is an anomaly,” says Associate Professor Pennell.

He goes on to explain that if you have an early blastocyst splitting into two embryos there’s an increased risk of issues in structural development.  The more severe anomalies can be picked up at the 11-13-week scan, however,