Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
Open Access

Managing Multiple Pregnancies: Causes, Risks and Effective Strategies

Aydan Rooman^{* *}Correspondence: Aydan Rooman, Department of Obstetrics and Gynecology, University of Valencia, Valencia, Spain, Email:

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Description

Multiple pregnancies, where a woman carries more than one fetus at the same time, are becoming more common in today’s society, due to factors like delayed childbearing, advancements in fertility treatments, and lifestyle changes. While multiple pregnancies can be a source of excitement, they also come with unique challenges and risks for both the mother and the babies. This article will analyze the causes, risks, and management of multiple pregnancies, as well as offer guidance on what expectant parents can do to ensure the best possible outcomes.

Causes of multiple pregnancies

Several factors can contribute to the occurrence of multiple pregnancies, including natural and medical causes.

Fertility treatments: One of the most common causes of multiple pregnancies is the use of fertility treatments. Medications like clomiphene citrate (Clomid) and gonadotropins are used to stimulate ovulation and increase the number of eggs released during a woman’s menstrual cycle, raising the chances of conceiving twins or more. In vitro Fertilization (IVF) can also result in multiple pregnancies, especially when multiple embryos are implanted to increase the chances of success.

Age: Women over the age of 30, particularly those in their late 30's, are more likely to conceive multiples, especially fraternal twins. As women age, their ovaries often produce more than one egg during ovulation, increasing the chance of multiple fertilizations.

Genetics: A family history of multiple pregnancies can increase a woman’s chances of having twins or more. Women with a history of multiple pregnancies in their family are more likely to produce more than one egg during ovulation (hyperovulation), which raises the chances of fraternal twins.

Previous multiple pregnancies: Women who have already had one set of multiples are more likely to conceive multiples in subsequent pregnancies. The body may be more likely to release multiple eggs again.

Body type: Women who are taller and heavier than average may have a slightly higher chance of conceiving multiples. This is not entirely understood, but some studies have suggested that higher body fat or a larger stature may be linked to the increased likelihood of releasing more than one egg during ovulation.

Diet: Some research suggests that women who consume a diet rich in dairy products or who have a higher intake of certain nutrients like folic acid may have a slightly higher chance of conceiving twins.

Risks of multiple pregnancies

While many women with multiple pregnancies go on to have healthy pregnancies and babies, there are inherent risks and complications associated with carrying more than one fetus.

Premature birth: Premature birth, defined as birth before 37 weeks of gestation, is more common in multiple pregnancies. Babies born prematurely may face a range of health issues, such as underdeveloped lungs, feeding difficulties, and jaundice.

Low birth weight: Multiple babies often have lower birth weights, which can lead to health complications, including difficulty maintaining body temperature, feeding problems, and an increased risk of infections.

Gestational diabetes: Women carrying multiples are at a higher risk of developing gestational diabetes, a condition in which high blood sugar levels occur during pregnancy. If left unmanaged, gestational diabetes can lead to complications for both the mother and the babies.

Preeclampsia: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organs, often the kidneys. Women carrying multiples have a higher risk of developing preeclampsia, which can be dangerous for both the mother and the babies if left untreated.

Placental problems: Women carrying multiple fetuses are at a higher risk of placental issues, including placental abruption (when the placenta separates from the uterus) and placenta previa (when the placenta covers the cervix). Both conditions can lead to heavy bleeding and complications during labor.

Cesarean delivery: Multiple pregnancies increase the likelihood of requiring a C-section (caesarean section) delivery. This is especially common when the babies are in abnormal positions or when one or more babies are in distress.

Higher risk of birth defects: Although the risk is still low, multiple pregnancies are associated with a slightly higher risk of birth defects, particularly for identical twins who share the same placenta.

Managing multiple pregnancies

Managing a multiple pregnancy requires close monitoring by a healthcare team. Women carrying multiples are typically monitored more frequently with ultrasounds and other tests to ensure the health of both the mother and the babies.

Regular prenatal care: Women with multiple pregnancies need to attend regular prenatal visits to monitor the growth and development of the babies. These visits will include ultrasounds to check fetal development, placental health, and amniotic fluid levels. Blood pressure, blood sugar, and protein levels are also monitored to prevent complications such as preeclampsia or gestational diabetes.

Nutrition and lifestyle: Maintaining a balanced diet and getting adequate nutrition is vital in a multiple pregnancy. Expectant mothers are often advised to consume extra calories, protein, and vitamins, including folic acid, to support the growth of more than one fetus. It is also essential to avoid smoking, alcohol, and excessive caffeine, all of which can harm the babies.

Birth planning: With the increased risks associated with multiple pregnancies, it’s important to have a well-prepared birth plan. A cesarean section may be required, and knowing the options and discussing them with a healthcare provider beforehand is important.

Conclusion

Multiple pregnancies bring both joy and challenge. While the thought of having more than one child is exciting, the increased risks require careful management and planning throughout the pregnancy. Regular prenatal care, proper nutrition, rest, and close monitoring by healthcare professionals can help ensure the best possible outcomes for both the mother and her babies. With advancements in medical care and fertility treatments, many women with multiple pregnancies go on to have healthy babies, and the possibility of successful outcomes continues to improve.