"What Are the Early Symptoms of Being Pregnant with Twins?"

Twin Pregnancy Complications and Considerations

Pregnant women carrying twins have an additional fetus in their uterus, resulting in increased production of related substances compared to singleton pregnancies. Consequently, early pregnancy symptoms such as nausea and vomiting tend to be more severe, primarily due to elevated estrogen levels. Additionally, the abdomen grows at a faster rate in twin pregnancies compared to singleton pregnancies. However, the initial symptoms of twin pregnancy are not significantly distinct from those of a singleton pregnancy.

Twin-to-Twin Transfusion Syndrome Manifestations

In twin-to-twin transfusion syndrome, the donor twin may experience anemia, growth restriction, and oligohydramnios (reduced amniotic fluid). Conversely, the recipient twin may exhibit polyhydramnios (excess amniotic fluid), macrosomia (large size), pericardial effusion, and edema. These are the fundamental manifestations of twin-to-twin transfusion syndrome. This syndrome predominantly occurs in monochorionic twins, where a single placenta is shared, and blood flow communication exists between the fetuses within the placenta. Sometimes, due to higher blood pressure in one fetus, blood is transferred to the other through these communicating vessels. Diagnosis of twin-to-twin transfusion syndrome relies on ultrasound, specifically when one fetus has excessive amniotic fluid (>8cm) while the other has reduced amniotic fluid (<2cm).

Precautions for Pregnant Women with Twins

The risk of preterm birth increases in twin pregnancies. Therefore, pregnant women should promptly seek medical attention if they experience abdominal pain or vaginal bleeding. Furthermore, knowing the chorionicity of the twins (monochorionic diamniotic or dichorionic diamniotic) is crucial, as both types pose higher risks compared to singleton pregnancies, with monochorionic diamniotic twins having the greatest risk.