Multiple pregnancy doctors are considered a condition requiring close monitoring. The fact that the female body is intended by nature for the normal carrying of just one child for one pregnancy, so that for two kids not always enough oxygen and nutrients, it becomes closely together, and this increases the risk of various complications.
Two or one?
Diagnosis of intrauterine development of multiple pregnancies is possible already in the early stages. Ultrasound can detect the presence of a second fetal egg at a period of 8-12 weeks, but the result of the first surveys still can not be considered final. There are cases when the fruits are arranged so that one hides the second behind them, and the detection of two fetal eggs does not yet mean their full development. In 1 trimester, approximately 15-20% of multiple pregnancies become single-parent due to the death of one of the eggs - it stops developing and remains in the uterus until the very birth.
Under supervision
If the survey shows that not one child has started to develop, the future mother will have to visit the women's consultation more often than others. In the 2nd trimester - every ten days, and in 3 - every week. In addition, the woman herself should take more care of her health and follow her condition, starting with weight (for multiple pregnancies, it should grow more than usual - the total increase for 9 months can reach 18-20 kg) and ending with signs of toxicosis, anemia, violations of the kidneys, heart.
Anemia is one of the most common complications when carrying twins. With "anemia", the number of red blood cells (red blood cells) and hemoglobin (oxygen transferring substance) in the blood decreases as anemia, as a result, a woman quickly becomes tired, constantly feels weak, her head turns dull and her skin turns pale, dyspnea, heart palpitations, in severe cases, it even goes to the loss of consciousness after a minor load.The most common anemia occurs with a lack of iron, as well as vitamin B 9 (folic acid), both substances are needed for development and growth but especially the placenta.If in normal pregnancy the risk of anemia is relatively small (especially if you take special medications - regular food can not always compensate for the increased need for iron), then in the presence of twins it increases dramatically, and with triplets without timely prevention of anemia is almost inevitable.What is the danger? One and a half times more likely to appear toxicosis, the risk of miscarriage rises to 40%, complications occur more often during childbirth, there may be problems with breastfeeding. Children born to anemia-afflicted mothers are more likely to get sick (they have lower immunity), are prone to allergic diseases.
How to avoid problems?
- Keep track of your condition, in time, contact your doctor.
- Take tests - anemia is determined by a routine blood test.
- Take prescribed medications. Exactly appointed! Not those that someone once prescribed, which you saw in advertising ... First, iron preparations for pregnant women have their own specifics, and secondly, the dosage for future mothers is selected individually, based on the results of analysis and general state. Do not self-relieve the dosage: if the medicine causes nausea (especially often it happens, of course, with toxicoses), you need to see a doctor and ask you to pick up another drug. If you can not swallow the pill at all, you'll have to do the injections. And certainly one should not hope for anemia only with an "iron-rich" diet.Fruits and vegetables, which in such cases "prescribe" various well-wishers, in general, are useful, just to provide iron and folic acid in such quantities, which are required for multiple pregnancies, they need to be eaten more than the healthiest and strongest person can.
Late toxicosis
Pregnancy in women with intrauterine development of multiple pregnancies occurs 4 times more often than in normal cases. From the usual to many toxicosis in the early stages, it differs, above all, in that it can cause much more trouble for children than for mothers. With gestosis, nausea and vomiting do not always happen, but there are hidden swelling, protein appears in the urine, blood pressure rises, and most importantly - toxicosis affects the placenta, disrupting the normal supply of baby (or kids) with oxygen and nutrients. Of course, this is not the best way to affect development, and especially (taking into account terms) - on the nervous system. And the birth of women with gestosis is usually complex ...
Predisposition to late toxicosis can be inherited, but all women who give birth too early (under 18 years) or later (after 35 years), all too often (between births of children less than two years old), mothers with many children with multiple, and with single-pregnancy pregnancies - with each child the risk increases). Strong or persistent stress of the future mother, Rh-conflict, hypertension and some other diseases are also very unfavorable factors.
How is it manifested? One of the first symptoms of gestosis can be a strong thirst, and the patient drinks a lot of water (and in general liquids - when counting, you must take into account both liquid dishes and all drinks), but the urine is much less. This indicates the violation of water-salt metabolism: most of the fluid is not eliminated from the body, but remains in the tissues and causes latent edema. If the restriction of drinking and salt in the diet does not help, if there is nausea, headache, dizziness, high blood pressure, you should immediately consult a doctor and follow all his prescriptions. Up to a possible hospitalization - with a multiple pregnancy in general, you need to be ready that such a measure sooner or later may be required because of a variety of problems, and even if everything is completely normal, already 2 weeks before the end of the normal period of bearing, doctors can take a pregnant woman under his constant supervision and begin preparations for childbirth.
Prevention of gestosis
Already in the 2nd trimester (and certainly absolutely - in the second half of pregnancy), it is necessary to refuse fried and spicy dishes, from spicy seasonings, smoked and salted. The latter condition is sometimes especially difficult for expectant mothers, but, alas - necessarily, otherwise it will be difficult to avoid edema. Chocolate will also have to be replaced with other sweets - due to a strong effect on the cardiovascular system. Eat well, walk in the fresh air more often and avoid stress as much as possible - mothers expecting twins, you need to watch yourself more closely than others.
Mild
Starting with the 2nd trimester, one more serious problem needs to be considered: the possibility of miscarriage and the termination of pregnancy. According to statistics, about 50% of women with multiple pregnancies face the threat of late delivery at one or another stage of gestation. It is believed that this is due to excessive stretching of the uterine muscles caused by too much of its volume. So, with any pain in the lower back and lower abdomen, a feeling of tension in the uterus, sudden discomfort, you should immediately seek medical help and, if necessary, go to the hospital for preservation: it is quite possible that doctors will have to take emergency measures to stop late birth and give the opportunity for children to develop normally. How to avoid problems?
Starting at 20 weeks, you need to stop playing sports (especially active species). Perhaps the doctor will recommend limiting the sexual life (it greatly affects the status of the uterus), if possible - do not work (and especially not postpone the maternity leave, which in case of multiple pregnancies is given from the 28th week) and except for a full night's sleep less than 4-6 hours, and by the end of the period - up to 8 hours. Do not miss the visits to the women's consultation. At least once every two weeks, the gynecologist should determine the condition of the uterus, especially the cervix: if it begins to shorten earlier than at the 23rd week, the so-called cervical cervical spine is performed - stitches are applied that will reduce the risk of premature birth. At later dates, tocolytic agents are used for the same purpose - special medicinal preparations.
It's time to give birth
For multiple pregnancies, several earlier terms of labor are characteristic - this should be remembered and not equal in our plans for routine calculations. After all, by the end of pregnancy, babies in my mother's stomach simply lack space, oxygen, or nutrition, and they are already sufficiently developed to continue their existence separately from the mother's body. Nature has taken care of such children as soon as possible: in case of a normally occurring multiple pregnancy, the more babies develop at the same time - the earlier their placenta "ages" and the whole female organism prepares for delivery.
For triplets, the normal term of birth is 34-36 weeks of pregnancy, twins have a little more time - up to 36-38 weeks. About 50% of twins are born with insufficient weight (by usual measures) - up to 2.5 kg, while between children there may be a difference in weight of 200-300 grams. If more (up to 1 kg), this already indicates problems with development one of them, but in a modern maternity home and this problem is usually solved: the difference in size is usually seen clearly with ultrasound, and the neonatologist will prepare everything necessary to help the premature baby. Let's notice, that much more problems deliver just large children - there are cases when at once two fetuses develop up to weight of 5-6 kg, thus and вынашивание it is strongly complicated (that it is no wonder - on a uterus it is necessary too big loading), and to give birth without the help of surgeons often simply impossible.
In general, the very process of delivery is not one, but several children, of course, much more complicated than usual. Therefore, in preparing for the reception of triplets (not to mention the more numerous addition of family) doctors usually recommend a cesarean section. Twins usually give birth in the same way as everyone else, although there may be difficulties. It is better not to give up a child if the doctors offer epidural anesthesia: in case of unforeseen complications, this will save time.