What Are Multiple Pregnancy Interventions?

The situation where the expectant mother carries more than one baby in her womb is called multiple pregnancy. An unexpected surprise for some expectant parents, this is often seen as a twin pregnancy. Twin pregnancies make up 1-2 out of 100 pregnancies of all pregnancies. Rarely, multiple pregnancies with more babies, such as triplets or quadruplets, can also be encountered. While it is an exciting experience, there are several risks, such as an increased risk of preterm birth for mothers with multiple pregnancies. Therefore, they should be more careful than other expectant mothers. In this article, we have compiled what you need to know about multiple pregnancy interventions.

Why Does Multiple Pregnancy Occur?

Under normal circumstances, when an egg is fertilized by a sperm, an embryo, or a baby, is formed. However, if two or more eggs mature in one cycle instead of one, each egg fuses with a sperm and a multiple pregnancy occurs.

Multiple pregnancies can occur naturally, as well as with assisted reproductive techniques, namely egg development (ovulation induction) and In vitro fertilization (IVF) treatment methods (such as in vitro fertilization). The frequency of multiple pregnancies has also increased with assisted reproductive techniques.

What Are the Risks of Multiple Pregnancy?

Multiple pregnancies carry risks that require more attention and monitoring during pregnancy. Therefore, multiple pregnancies require special follow-up and health follow-up for mothers and babies. Good prenatal care, regular doctor check-ups and taking the necessary precautions are important in terms of protecting the health of both mothers and babies. We can list the risks that may occur in cases of multiple pregnancy as follows:

• Premature birth: The risk of preterm birth in twin pregnancies is approximately 50%, and this rate is higher in triplet and higher pregnancies. Premature babies; they encounter developmental problems, respiratory distress and other health problems at much higher rates.

• Low birth weight: Twin pregnancies tend to be born smaller than singleton pregnancies, both because they are born earlier and because they are prone to growth retardation. Low birth weight poses a risk to the health and development of babies.

• Gestational diabetes: Multiple pregnancies, gestational diabetes is seen approximately 1.5 times more in expectant mothers. Gestational diabetes is a type of diabetes that occurs during pregnancy and can cause complications such as growth problems, respiratory distress and increased amniotic fluid in babies.

• Pregnancy poisoning (preeclampsia): In multiple pregnancies, the risk of high blood pressure increases, and it is seen approximately 3 times more than in singleton pregnancies. This condition, called gestational hypertension, can lead to serious complications for mothers and babies.

• Iron Deficiency Anemia: Iron deficiency anemia is seen much more frequently than singleton pregnancies.

• TTTS, twin-to-twin transfusion syndrome: It is a complication specific to identical twins. Identical twins share the same placenta. For this reason, this condition, also called blood stealing from each other, affects almost one-third of identical twins.

Exactly how high these risks are; It depends on how pregnancies are managed, maternal health, and other factors. For all these reasons, multiple pregnancies should be examined by a perinatology specialist at least twice. In addition, if these complications occur, they should be followed up by a perinatologist.

What are Multiple Pregnancy Surgical Interventions?

In cases of multiple pregnancy, various interventions and measures can be taken to protect the pregnancies and the health of the mother in the best possible way. We can list some of the frequently used interventions in multiple pregnancies as follows:

• Multifetal Reduction: If the number of pregnancies is three or more, reducing the number of pregnancies to 2 is the method recommended all over the world. In this way, the chance of survival and sequela-free survival of the remaining fetuses is significantly increased. This process is done between 11-14 weeks.

• Stopping the fetus with anomaly: In both monozygotic and fraternal twins, if one of the fetuses is too abnormal to survive or has severe sequelae, it may be necessary to stop the heart of one of the babies both to protect the other fetus and not to risk maternal life.

• TTTS Laser ablation: In the disease called TTTS, the vascular connections between babies can be treated with a surgery called fetoscopic laser.