The delightful diagnosis of twins also carries the realistic speculation that the pregnancy issues with twins may be higher. Miscarriage, intrauterine fetal death, fetal loss, placental troubles, pregnancy based hypertension, unequal (discordant) fetal development, genetic along with biochemical and "positional" fetal disorders, and specifically preterm labor all are witnessed with more frequency in a multi-fetal pregnancy.
Miscarriage occurs at nearly three times increased rate with several fetuses. If the babies are "monozygotic" or identical (developed from the same egg), the risk multiplies as it happens with other pregnancy issues with twins as well.
The assurance that can often be provided to women after witnessing the fetal heart on ultrasound does not importantly extend to pregnancy issues with twins. As twins are more prone to suffer other disorders, assessment of the fetal heart, while somewhat reassuring, is not actually a reassuring.
One of the ideal indications of expected miscarriage in twin pregnancy is a difference of 3 mm or more between the twin gestational sac diameters or between the twin crown-rump length in subsequent gestations. When such disorder is viewed, the percentage of miscarriage enhances.
Miscarriage may influence only one baby. The presence of a "vanishing twin" syndrome has been displayed with a prevalence rate of about 21 percent. In this case, one twin is blocked leaving the other twin to develop normally. This situation is more often reported in scans performed before 12 weeks.
A large number of mothers carrying twins in this decade have been offered with some type of fertility treatment. Such women are mostly older and the literature shows that infertile women have an immense increase in spontaneous pregnancy loss even after the early confirmation of fetal cardiac activity. Besides this, an abrupt enhancement in spontaneous abortion rates was witnessed in women over the age of 35 years.
A recent study from a previously infertile population displayed a seven percent event of spontaneous abortion after the early diagnosis of fetal cardiac activity by ransvaginal ultrasonography. Yet another study analyzing pregnancy outcomes in 293 pregnancies in previously infertile women with early detection of fetal cardiac activity found an incidence of instinctive pregnancy loss of 11 percent.
Miscarriage, among other pregnancy issues with twins, is mostly also reported frequently with increased maternal age in fertile women. A study in a fertile population examined the transabdominal sonograms of women presenting prior to 10 weeks of gestation for prenatal care. The average loss percentage after viewing the fetal heart was 2.1 percent. In this evaluation of fertile women, the miscarriages were reported from 1.6 percent to 2.6 percent for patients below 39 years of age. A miscarriage rate of 13.6 percent was reported in patients older than 40 years of age.
Ultrasound diagnosis of fetal cardiac movement has been displayed to have increased positive predictive value for germination than the availability of either a gestational sac alone or the facilitation of biochemical markers. The existence of fetal cardiac motion by transvaginal ultrasound in earlier infertile women aged below 30 years is immensely reassuring. According to one study, no pregnancy issues with twins are witnessed in these women after detection of fetal cardiac activity within 35 to 42 days post ovulation.
Hence, patients above 35-years-old must be suggested that their vulnerability of spontaneous abortion is prominent even after early diagnosis of fetal heart motion by transvaginal ultrasound. Furthermore, earlier infertile women who have crossed 40 years of age should be intimated that their vulnerability of pregnancy issues with twins is increased fivefold compared to women of 31 to 35 years of age. Despite the expected engendered by the early diagnosis of fetal cardiac activity by transvaginal ultrasound, the activity is monitored in these patients to a minimum of 10.4 weeks, when miscarriage rates should diminish.
In spite of all this, a twin pregnancy has a nice chance of being a healthy pregnancy. With proper care, support and right nutrition, there is a high probability for warding off all pregnancy issues with twins. The pregnancy will go to term or close to term and you will have give birth to two healthy babies.