ASRM Fact Sheet on Pregnancy with Multiples

March 19, 2015

From the American Society for Reproductive Medicine (ASRM) fact sheet on What do I need to worry about with a multiple pregnancy?

What are some problems with having a multiple pregnancy?

Pregnancy loss
The more fetuses there are in the womb, the more likely it is that the pregnancy will end in miscarriage, premature delivery, or stillbirth. Sometimes one or more of the fetuses will no longer be seen with ultrasound, called vanishing twin syndrome. In fact, 1 out of 3 pregnancies with more than one fetus will naturally reduce its number very early in pregnancy.

Problems for the babies
Many problems are linked to the babies being born early (prematurity). Premature babies can have problems with their lungs, stomach, and bowels, and even die. Some require long stays in the neonatal intensive care unit. Prematurity can also cause problems with bleeding in the brain, which can lead to problems with the baby’s nervous system and development. Prematurity can cause problems with movement and mental retardation, including cerebral palsy. Some problems may not be noticed until the children are older.

Problems for the mother
The risk of pregnancy complications goes up with each fetus in the womb. Some women can develop high blood pressure in pregnancy, called preeclampsia or toxemia of pregnancy. This can be dangerous and it can cause preterm birth, seizures, and, in extreme cases, death of the mother. Gestational diabetes (problems with high blood sugar) is more likely with a multiple pregnancy. In the early stages of a multiple pregnancy can also have more nausea, vomiting, and constipation than a woman carrying one baby. Problems with bleeding before and after the delivery are also more common.

What can I do if I have a multiple pregnancy?

If you are carrying more than one fetus, talk with your doctor and partner about your options. Multiple pregnancy often means specialized obstetric care, especially for triplet and other high-order multiples. Many complications cannot be prevented, but getting good care is important to reduce your risks. Some women may choose to have a procedure called multifetal pregnancy reduction. This can be used to reduce the number of fetuses to a smaller number to increase the chances of having just one or two healthy child(ren). Women with serious health problems may consider this necessary to make the pregnancy less risky.

ASRM is an excellent resource for reproductive facts. Please check out their patient resources website at https://www.reproductivefacts.org/.

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