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Multiple Pregnancy: Twins or More - Treatment Overview

Always be sure to take extra good care of yourself when you are pregnant. When carrying twins or more (multiple pregnancy), be sure to eat a balanced and nutritious diet of quality calories. And make sure that you get enough calcium, iron, and folic acid.

You can expect to gain weight more quickly than you would with one fetus. With each additional fetus a woman carries, her range of weight gain will increase.

Your range of healthy weight gain will be different if you started your pregnancy underweight or overweight.

High-risk pregnancy care

If you are pregnant with twins or more, good prenatal care will help you and your health professional prevent and watch for problems. You will have more frequent checkups than you would for a pregnancy with one fetus.

Complications can occur at any time during and after a multiple pregnancy. These include medical complications that:

Affect the mother and fetuses, such as miscarriage, preterm labor and/or preterm birth, preeclampsia, gestational diabetes, and serious placenta problems.
Affect the fetuses before birth, such as vanishing twin syndrome, twin-to-twin transfusion, and a higher risk of disability and genetic disorders.
Affect the newborns because of premature birth, such as lung, brain, heart, and eye problems.
Result in long-term disability for the babies. These can include mental retardation, cerebral palsy, learning disabilities, blindness, or deafness. These are most likely among babies born before 28 weeks.

Because you are more likely to deliver early, be sure to plan ahead. Ask your health professional about making arrangements to deliver at a specially equipped hospital. Such a hospital has facilities for emergency cesarean delivery and a neonatal intensive care unit (NICU).

Early pregnancy decisions about triplets or more

When there are three or more fetuses in the uterus, their risks of disability or death are higher with each additional fetus. If you are carrying triplets or more after infertility treatment, your doctor may offer the option of multifetal pregnancy reduction (MFPR) near the end of your first trimester. A successful MFPR increases the chances of healthy survival for the remaining fetuses and reduces risks to you. But MFPR sometimes leads to miscarriage.¹

The decision to have a multifetal pregnancy reduction is difficult and traumatic. If you are faced with this decision, talk to your doctor about your personal risks from trying to carry multiple fetuses to term compared to the risks of choosing MFPR. Also consider discussing your decision with a counselor or spiritual advisor.

Multiple pregnancy: Should I have a multifetal pregnancy reduction?

Preterm labor is more common in a multiple pregnancy than in a pregnancy with one fetus. If you go into preterm labor and premature delivery is likely, your health professional may recommend taking one or more precautions, such as:

Limiting your activity level.
Staying in the hospital. This is often so that you can receive steroid medicine to help your babies' lungs develop faster. In some cases, tocolytic medicine is used in an attempt to delay preterm birth. You are closely watched if you are treated with a tocolytic medicine. Complications of some tocolytics, such as pulmonary edema, are more common when you are carrying twins or more.²

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WebMD Medical Reference from Healthwise

Last Updated: October 26, 2009

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.