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Antenatal care

A good and regular (3-4weekly) follow is utmost important in women with twin pregnancy. This not only helps to monitor the growth of the babies, but also enables to pick up early complications and therefore helps in management.

Ultrasonography are done as in normal pregnancy i.e. at 11-12 weeks, at 20 weeks, at 32-34 weeks. Additional sonography may be advised if the obstetrician suspects some abnormalities. A Doppler sonography wherein the blood flow to the babies is evaluated may be done one or two times between 28-34 weeks or as suggested by the obstetrician.

Other than monitoring the growth of the babies some things which sonography may help in is the location of placenta (After births), position of babies (Head down or feet down), and cervical length( length of mouth of uterus)Blood tests may be done more frequently almost every 11/2 to 2 months for early detection of anemia, deranged blood sugar etc.


Prevention of complications

    • Regular antenatal check ups, frequent Ultrasonography and blood tests.
    • Oral supplements for iron, vitamins, calcium and proteins. Very rarely if the women does not respond to medical management, supplements may be given in intravenous form.
    • Cervical os tightening (Stitch taken at the mouth of uterus) in certain selected cases where in there are high chances of mouth of uterus opening very early in pregnancy.
    • Prophylactic betamethasone injections at 7-8 moths to facilitate fetal lung maturity in case of premature birth and thereby reduce fetal morbidity.
    • Additional drugs like L-Argine or ecosprin low dose to prevent PIH.

Delivering Bundle Of Joy

If all goes well, delivery is usually planned around 36-37 weeks. If a cervical knot is taken, then the most suitable time to cut it is around 36 weeks. Mode of delivery whether normal or cesarean depends upon the gestation period, location of placenta, the weights and condition of babies and position of babies. Depending upon all these factors the obstetrician will sketch a plan after discussing with you and your partner. It is always better to deliver at a place where NICU facilities are available as one or bothe the babies may need some initial care.

Trimester Chart

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1st Trimester

0.4kg - 2.0kg

2nd Trimester

2.0kg - 8.0kg
*units in weeks

3rd Trimester

8.0kg - 13.6kg