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What is a Multiple Pregnancy?

Multiple pregnancies comprise of two or more fetuses such as:

• Twins–two fetuses
• Triplets–three fetuses
• Quadruplets–four fetuses
• Quintuplets–five fetuses
• Sextuplets–six fetuses
• Septuplets–seven fetuses

No doubt, multiples account for only a small percentage of all births (about 3 percent), and the multiple birth rate is indeed rising.

What causes multiple pregnancies?

There are several factors that are related to having a multiple pregnancy. Here are a few:

• Heredity

A family history comprising of multiple pregnancies does increase the chances of having twins.

• Older age

Women above 30 do have a greater chance of multiple conceptions. Many women today are indeed delaying childbearing until later in life, and may do have twins as a result.

• High parity

Having one or rather even more previous pregnancies, especially a multiple pregnancy does indeed increase the chances of having multiples.

• Race

African-American women are indeed more likely to have twins than any other race. Asian and Native Americans do have the lowest twinning rates. Caucasian women, especially those above 35, no doubt have the highest rate of higher-order multiple births (triplets or more).

Other factors that have greatly enhanced the multiple birth rates in recent years do include reproductive technologies that include the following:

• Ovulation-stimulating medications, such as clomiphene citrate and follicle stimulating hormone (FSH) that help produce several eggs, which, in case are fertilized, can also result in multiple babies.

• Assisted reproductive technologies–in vitro fertilization (IVF) and other techniques can also be of help to couples to be able to conceive. These technologies often tend to make use of ovulation-stimulating medications in order to produce multiple eggs, which are then fertilized in the laboratory and then returned to the uterus for developing.

How do multiple pregnancies occur?

Multiple pregnancies usually tend to occur when more than one egg is indeed fertilized and then it is implanted in one’s uterus. This is often called fraternal twinning as it can indeed produce boys, girls, or a combination of both. Fraternal multiples are just simply siblings that have been conceived at the same time. However, just as siblings often do look alike, fraternal multiples may also look very similar. Fraternal multiples each do indeed have a separate placenta and amniotic sac.

At times, one egg is fertilized and then they are divided into two or more embryos. This is rather called identical twinning and does produce all boys, or all girls. Identical multiples are genetically identical, and they are usually looking so much alike that even parents have a hard time telling them apart. However, these children do have different personalities and are rather distinct individuals. Identical multiples may have individual placentas and amniotic sacs, but most do share a placenta with separate sacs. It is rare that identical twins do share one placenta as well as a single amniotic sac.

A multiple pregnancy is when one is pregnant with twins, triplets or more. Three babies or more is referred to as a ‘higher order’ pregnancy, and it is rather rare – occurring in just 1 in 50 multiple pregnancies.

Having triplets or more can be challenging, but most families find having several babies at once a positive experience.

How do multiple pregnancies occur?

Multiple pregnancies occur when more than one embryo implants are there in one’s uterus (womb). This can also happen if one releases more than one egg during the menstrual cycle and each of the egg is indeed fertilized by a sperm. Sometimes, a fertilized egg does spontaneously split into 2, thus resulting in identical embryos.

Multiple pregnancies are now more common than they used to be, on account of the increasing use of in vitro fertilization (IVF).

Fertility drugs often do cause more than one egg to be released from the ovaries. IVF can also result in multiple pregnancies if more than one fertilized embryo is transferred to the uterus and develops. Sometimes, one of these eggs may also split into twins after it is transferred.

Women aged 35 and older are indeed more likely to release more than one egg during the ovulation period, so they are of course more likely to have multiple pregnancies. One is also more likely to have multiple pregnancies if one has a history of twins in one’s family.

Diagnosis of multiple pregnancies

Signs of multiple babies occurring:

• One gains weight rapidly at the start of the pregnancy.
• One has severe morning sickness.
• More than one heartbeat does get picked up during the prenatal examination.
• The uterus is rather larger than expected.

Types of multiple pregnancies

The most common types of multiples are:

Fraternal twins

Two separate eggs are indeed fertilized and implanted in one’s uterus. The babies are of course siblings who do share the same uterus and they may also look similar or different, and may be either be the same gender (2 girls or 2 boys) or of different genders.

Identical twins

Identical twins are rather formed when a single fertilized egg is split into halves. Each half (embryo) is no doubt genetically identical so that the babies can share the same DNA. This does mean that the babies will indeed share many of the characteristics. However, on account of their appearance is influenced by the environment as well as by genes, at times these identical twins can indeed look quite different. Identical twins may also share the same placenta and amniotic sac, or they may have also their own placenta and amniotic sac.

Triplets and ‘higher order multiples’ (HOMs)

Triplets, quadruplets, quintuplets, sextuplets or perhaps, even more, can be indeed a combination of both identical as well as fraternal multiples. For instance, triplets can be either fraternal (trizygotic), thus forming 3 individual eggs that are fertilized as well as implanted in one’s uterus, or even they can be identified when one of the egg divides into 3 embryos; or perhaps, they can be a combination of both.

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