
Generally, the changes in the mother are more severe than in a singleton pregnancy. There is often more nausea and vomiting. Blood cell counts and hemoglobin levels are lower. This is called “physiological anemia”. The need for iron and vitamins is higher. Blood loss at birth is also higher. The physical discomfort is greater as the abdomen will reach a larger volume earlier. The last trimester is particularly difficult for these pregnant women, as there is more pressure on the lungs. Pregnancy stress and the risk of maternal complications are always higher. Miscarriage rates are higher. The risk of malformations is higher (2% major, 4% minor). Low birth weight and preterm delivery are characteristic. It is known that one baby may be born with a significant difference in weight and development, with more blood than the others. It is recommended that more than two babies are converted to twin pregnancies before 12 weeks of gestation by a procedure called reduction.
The gestation period, which normally lasts 40 weeks, is accepted as 38 weeks for multiple pregnancies. After 38 weeks, weight loss may start in multiple pregnancies. While the pregnancy continues, sometimes one or more of the multiple pregnancies may die in the womb. While such a situation does not pose a significant risk for the mother in the early period, it may lead to clotting disorders in the mother in the following months. The daily need for vitamins and folic acid increases during pregnancy. The incidence of hypertension increases to 15%. Pregnancy is monitored more closely with tests such as Doppler ultrasound and fetal monitor. Bed rest is recommended to prevent premature birth. Cortisone treatment is recommended for lung development. The physician will decide on vaginal or caesarean delivery according to the position of the babies.
Since multiple pregnancies are risky pregnancies, they must be followed by a specialist physician and delivered in a hospital with a neonatal intensive care unit.