Expecting Multiples: HCG Screening and Multiple Pregnancy
Due to increased and more effective fertility treatments, multiple pregnancies are becoming more common. Since 1980, there has been a 70% increase in twin births and a 400% increase in pregnancies comprised of three or more babies. In many of these pregnancies, HCG screening is a widely-used tool to both detect and monitor a multiple pregnancy.
What is HCG?
HCG is a medical acronym that stands for human chorionic gonadotropin. In layman’s terms, HCG is the hormone that a fertilized egg releases upon conception. HCG levels are the highest during early pregnancy. The hormone enables a mother’s body to accept and nurture the egg before her own hormone levels have increased to the point where she can independently sustain the pregnancy. Once pregnancy is firmly established, the role of HCG becomes less important as the placenta takes over the responsibility of regulating pregnancy hormones.
Early HCG Detection
One of the earliest HCG screenings that a pregnant mom will experience is the home pregnancy test, which tests for HCG in the urine. Even the simplest home pregnancy test uses HCG levels to indicate either a positive or negative result. Some pregnancy tests are more sensitive than others and some women produce higher levels of HCG sooner and can get earlier positive results from a home pregnancy test. In most cases, moms who have had their last period 28 days or less before testing will have little variation in HCG levels between single or multiple pregnancies. By the time 33 days have passed, however, the difference is significant. Multiple pregnancies generally produce higher levels of HCG earlier in the pregnancy.
Medical HCG Screening
Once a home pregnancy test has shown a positive result, your doctor will likely start blood screening for HCG levels. This is especially critical if you are carrying three or more babies. Your HCG levels can indicate the viability of the pregnancy and ensure that all babies are growing as expected. Still, HCG screening is just a tool, so don’t become alarmed if the results aren’t what you expect. Your doctor has numerous other monitoring and screening tools to keep tabs on your babies.
How Twins are Conceived
Fraternal twins, or dizygotic twins, are the more common type of twins. They are conceived when two separate sperm fertilize two eggs, and each has separate amniotic sacs and placenta. However, the placentas may fuse during the pregnancy and appear to be just one by the birth. These twins are as genetically different as any two siblings with the same parents. They may be of the same or opposite sex.
Identical twins, also called monozygotic twins, are conceived from a single egg. After being fertilized by one sperm, the egg splits into two embryos which grow into two babies. Identical twins may share one placenta, but they often have separate amniotic sacs, depending on how early the egg splits. The babies will always have identical genes and therefore the same sex and appearance. However, environmental factors beginning in pregnancy result in differing characteristics, such as different fingerprints and birthmarks.
In very rare cases, a late and incomplete split of the embryo results in conjoined twins.
Chances of Conceiving Twins
According to twin-pregnancy-and-beyond.com, the odds of having fraternal twins may be increased by certain factors. These odds have also been on the rise for decades due to recent trends in pregnancy. For instance, in vitro fertilization may boost the odds of conceiving fraternal twins by as much as 32%. Certain fertility drugs can increase the chances of fraternal twins by 10-20%. In addition, any or all of the following factors can contribute to conceiving fraternal twins: women who are over 35, who have twins on either side of their family, who are above average weight and height, who already have a set of fraternal twins.
However, there seems to be no determining factor for conceiving identical twins. According to babycenter.com, chances have been 1 in 250 for many decades all over the world.
Signs and Symptoms of Multiple Pregnancy
Millions of women conceive every year with no help from technology. However, for a significant number of mothers, fertility treatments are necessary to achieve a successful pregnancy. While multiples are often conceived naturally, usually in the form of twins, using fertility treatments increases a couple’s chance of achieving a multiple pregnancy. If you are an expectant mother, here are some signs and symptoms that you could be carrying more than one baby.
Early Signs of Multiple Pregnancy
Many multiple pregnancies are detected earlier in the gestational period because HCG levels spike sooner and more intensely. Most expectant mothers will also have earlier and more severe morning sickness with multiples due to this spike. As pregnancy progresses, uterine growth is accelerated. While women who have undergone fertility treatment are probably expecting these symptoms, naturally conceived twins can be a big surprise, so a more firm answer is always preferable to relying on early indicators. While having symptoms does not mean that you have more than one baby, they could be good indicators that further testing is needed.
Seeing Your Doctor
The best way to determine if a multiple pregnancy has occurred is to see your doctor. One of the earliest signs of multiple pregnancy that your doctor can pick up is your babies’ heartbeats. In many cases, this is the first sign of a multiple pregnancy in women who are carrying naturally conceived twins. In women who achieved pregnancy via fertility treatment, age and medical history will be assessed. Women who are older than 35, have had multiples before or were taking birth control pills prior to conception are more likely to carry multiples.
Of course, early symptoms are only clues. Eventually, an exact picture of the multiple pregnancy is needed. In order to determine for sure if you are carrying multiples and how many, the ultrasound is the ultimate tool. In a suspected multiple pregnancy, ultrasounds will probably begin early and continue at regular intervals to monitor the health and condition of your babies.
Weight Gain with Multiple Pregnancy
After years of watching their weight, many newly-pregnant women may view their pregnancy as a license to eat anything they desire. Unfortunately, this isn’t recommended. The topic of weight gain during pregnancy is a serious one, and the subject becomes even more important in cases of multiple pregnancies. Pregnancy experts from Kidshealth.org advocate that weight gain is critical for the health of the developing babies, but other experts, such as researchers from the March of Dimes, warn that excessive weight gain can lead to complications such as premature birth.
Extra Weight Gain Required
There’s no question that a multiple pregnancy requires that the mother increase her intake of calories, and at a greater level than a mother who is carrying a single baby. While the exact recommendations for weight gain can vary with each mother-to-be and should be discussed with the obstetrician, general guidelines provided by Americanpregnancy.org are that women carrying twins should gain a total of 35 to 45 pounds over the course of their pregnancy, while mothers of triplets should gain in the range of 50 to 60 pounds. This translates to roughly 300 extra calories a day for each baby, although weight gain is most important during the second and third trimesters.
Making The Calories Count
Not all calories are equal when it comes to providing the best nutritional value for a developing fetus. As tempting as it may be to load up on foods like chips and desserts, medical experts recommend assessing the nutritional content of foods before eating. Lean toward choices that pack the most nutritional punch. According to the March of Dimes website, women who are pregnant with multiples require extra folic acid and calcium. Foods that are high in these nutrients include milk, fortified orange juice, broccoli, and sardines.
Many women today want to breastfeed their babies, but when they find out they are expecting multiples, they may think twice. Is it really possible to breastfeed multiples? In fact, with support, preparation, and the appropriate accommodations, most women can breastfeed multiples just fine.
Before the Birth
Mothers of multiples who want to breastfeed will need to locate a health care practitioner who will support their desire to breastfeed. They may wish to rent a hospital-grade breast pump. It is also very important for women who are pregnant with multiples to line up housekeeping help for the days and weeks after the birth since they will be very busy learning about and caring for their new babies.
In the Hospital
According to the La Leche League, initiating breastfeeding as soon as possible after the delivery is ideal for the production of breast milk. However, women who are pregnant with multiples are more likely to have surgical or preterm births, which can delay their first nursing session for several hours or even longer. These mothers may need to pump to stimulate their milk supply. The colostrum and milk can then be fed to the babies through a medicine dropper or syringe to avoid nipple preference.
Breastfeeding on demand, or according to the baby’s cue, is one of the best ways to ensure adequate milk supply, but when there are multiples this can be exhausting for the mother. She may wish to develop a flexible feeding schedule in order to get some much-needed rest for herself.
As mothers of multiples become more adept at breastfeeding, they may wish to tandem-nurse, or nurse both babies at once. According to Dr. William Sears, a fellow of the American Academy of Pediatrics, the double clutch, double cradle, or double football hold are all popular holds for mothers of multiples. Babies should be alternated between breasts, and pillows may be used to ease the burden on the mother’s arms.
Getting Ready for Twins And Multiples
Multiple births are becoming increasingly common in modern pregnancies, especially for women who participate in fertility treatments. Twins are the most common form of multiple-birth. When expecting twins, there are a few things that need to be considered.
It is a well-known fact that twins tend to be born earlier than single pregnancies. This makes it a good idea to begin preparing as soon as possible. It could be stressful to bring your babies home to a room that is not quite finished or not have enough supplies for both children. Another reason to start early is that a twin pregnancy can be more uncomfortable and make it more difficult to get around than a single pregnancy. It will be easier to do the shopping and set things up in the first or second trimester.
It is vital for both the mother and her children that she receives the necessary nutrients and calories to support all three. It is recommended that an expecting mother consume an additional 300 calories per baby. This is not the time to worry about weight gain. Taking prenatal vitamins will help ensure the mother and children consume plenty of iron, calcium, and folic acid. This will help them remain healthy as well as help prevent birth defects and disorders, such as spina bifida. Nutrition is especially important if the mother intends to breastfeed her twins. If intending to breastfeed multiples, it is a good idea to consult a doctor.
Two children are obviously more expensive than one, so it is a good idea to make changes to your budget to accommodate these expenses as soon as possible. Many things can be bought in bulk, since newborn twins can share things like clothes, diapers, and entertainment items. This saves money for larger items that cannot be shared such as the cribs. With some preparation, having twins will be the wonderful experience it should be.
What to Expect with Bed Rest
Whether conceived naturally or via fertility treatments, finding out that you are expecting multiples can be both exciting and alarming. While many aspects of a multiple pregnancy will progress normally, there is also a higher likelihood of complications occurring. Because of this, bed rest is a common precaution for women expecting multiples. Knowing what to expect can make this time more productive and easier to deal with.
When Bed Rest is Ordered
Most preterm twins are delivered around 36 weeks. Triplets are regularly carried to around 32 weeks, while quadruplets rarely stay put for more than 30 weeks. Almost all multiple pregnancies of three or more babies are delivered prematurely. Bed rest is usually ordered from a few weeks to a month before the significant risk period commences. The actual recommendation of your care provider will be based upon both statistics and your own pregnancy history. If you are carrying twins and experiencing no complications, bed rest may start closer to 36 weeks. However, if you have already had symptoms like high blood pressure or significant preterm labor, your doctor may place you on bed rest sooner. The most cautious doctors begin bed rest on all multiple pregnancy moms by 24 to 28 weeks.
What to Expect
Many women imagine bed rest as a lovely time to kick back, relax and have a good excuse to do nothing. This may be true for the first week or two, but it can get old fast. Have a variety of activities on hand to stay busy and entertained. Some moms of multiples take up craft projects. You can also schedule regular visitors to keep your mind diverted. Finally, make sure that you have nutritious food on hand. Low birth weight is a significant risk in multiple pregnancies, so your diet during bed rest is of utmost importance.