Twins:Complications

What is vanishing twin syndrome?

Carrying twins does put you in the high-risk category, but that does not mean you'll develop complications. Most twin pregnancies result in healthy babies and healthy moms, too.

Miscarriage
Unfortunately, your chances of having a miscarriage are higher when you're carrying more than one baby. That's mostly because the risk of chromosomal abnormalities is higherin a pregnancy with twins. And the chances that you'll lose one baby after 20 weeks or in the first month after birth are more than twice as high. A miscarriage is more likely if you're pregnant with identical twins, or triplets, or more.If you do miscarry one twin, the chances are low that something will go wrong with the surviving baby. And the earlier the loss, the less likely you are to develop complications. In fact, the majority of remaining twins survive when the other twin miscarries.

Vanishing Twin Syndrome
Another common potential problem in pregnancies with more than one baby is the so-called vanishing twin syndrome. This is most often detected early. An ultrasound will detect twins in the first trimester but only one grows to term. Why this happens is not completely understood. The lost twin is reabsorbed into the mother's body or miscarried with little or no warning and few or no symptoms--unlike a regular miscarriage, where you normally have cramping and bleeding.

Preeclampsia

Preeclampsia is a pregnancy-induced high blood pressure disorder. It is twice as common in women carrying multiples than in single pregnancies. It develops in about 10 to 20 percent of women carrying twins. The condition also tends to develop earlier and be more severe in women carrying twins or more babies. These complications can be very dangerous to both you and your baby if left untreated. Your health care provider will be sure to screen you for these illnesses at each of your prenatal appointments. With appropriate care, preeclampsia and gestational diabetes can be managed safely.

Placental Abrubtion
Placental abruption is a serious condition that needs immediate medical attention. It occurs when the placenta detaches from the uterine wall before delivery. It is also more common when you're carrying more than one baby. But the condition is mostly linked to malnutrition and smoking, and is rare in well-nourished expectant mothers. Placental abruption can lead to preterm labor and delivery and is responsible for about one in five twin deaths late in the pregnancy or in the babies' first month outside the womb.

Fetal growth restriction

Fetal growth restriction may cause the babies to be born prematurely or at a low birth weight. It happens when one or both babies are not growing properly. Up to almost half of pregnancies with more than one baby have this problem compared with slightly more than 10 percent of single pregnancies.

Twin-twin transfusion syndrome
Twin-twin transfusion syndrome is a rare but serious complication occuring in identical twins. This occurs when one baby takes the other's blood supply. One baby somehow gets too much blood and the other too little. Until recently, severe cases meant the death of both babies, but these days survival rates are much higher thanks to early detection. If you are expecting twins, it is important to get checked out for TTTS. This syndrome sometimes occurs in twins that are sharing a single placenta (known as a monochorionic placenta). In TTTS, abnormal blood vessels form inside of the placenta, disrupting the proper flow of blood, oxygen, and nutrients. As a result, one twin can become severely undernourished while the other becomes over-nourished. TTTS is a very dangerous syndrome that requires immediate medical attention. Your health care provider will monitor you for TTTS if you are expecting twins.

Acardiac Twin
Acardiac twin syndrome is very rare. It occurs in 1 out of every 35,000 twin pregnancies. One of the twins is normal (also known as the pump twin) and the other twin is only body-like tissue with legs and a lower body (known as the acardiac twin). The upper body and heart are not present. However, abnormal blood vessels on the placenta allow the normal twin to pump blood through the tissue of the abnormal twin. There is an extremely high risk that the normal baby will suffer heart failure because it is pumping for two. Unless the baby is mature enough to be delivered, the condition can be fatal. The harder the normal baby's heart has to work, the greater the risk of fatal heart failure is. Ultrasound tests can detect this condition. If heart failure is identified and the pregnancy is far enough long, the baby will be delivered. If the acardiac twin is large enough and your doctor is concerned about the healthy baby being at risk for heart failure, your doctor can stop the blood flow to the acardiac twin. This is done through fetal image-guided surgery. A thin needle is guided into place ,via ultrasound, where the blood vessels feed into the acardiac twin. A tool called a radio-frequency ablation produces extreme local heat and burns the tissue of the acardiac twin to burn and destroy the blood vessels, which will stop blood flow. No incision is necessary and the pain and recovery time is generally minimal.

Preterm Labor
Labor occuring earlier than the 37th week of pregnancy is known as preterm labor. Preterm labor is one of the most common complications associated with twin and multiple pregnancies. Labor often occurs early because there is simply not enough room inside of your uterus for the babies to grow any bigger. Preterm labor occurs in more than 50% of twin pregnancies and in more than 90% of triplet pregnancies; women expecting higher-order multiples are almost 100% likely to go into preterm labor. Because of these risks, you may be required to engage in bed rest for a short period throughout your pregnancy, particularly if you are expecting triplets or more. However, regular prenatal care throughout your pregnancy will help to reduce your risk of preterm labor by as much as 10%. Try to become as familiar as you can with the signs of labor, so you will know exactly what to do should labor begin early

Comments: Twins - Complications

Comments 1 to 4 of about 4.

jridener - 398 days ago.
Hi i am now 11 wks. Two weeks ago I started bleeding really bad and thought i was having a miscarriage.When they did the ultrasound they told me i had one healthy baby and had lost the twin but didnt know i was even pregnant with twins. I am terrified now of losing the other and still spotting. has or is anyone else going through this. I cant sleep at night for worrying!!!

jaynzacksmom - 938 days ago.
Hi Everyone, I am 15 wks 4 days and about 5 wks ago I lost one of my twins. But i went to the doctor about a week and a half a go and the baby that didn't make it, her sac looked bigger than the healthy baby. Can this actually happen? should I be worried? My doc just said he didn't know why the other sac looked so much bigger where the baby had quit growing.

carrieklin - 1282 days ago.
I had an ultrasound two weeks ago when my doctor told me there was a fetus as well as some debris....then just last week he said there are two babies and it looks like they both have heartbeats but it is hard to tell. I have had a small amount of bleeding but no paid over a couple of days after the last ultasound and I am praying it was due to the vaginal ultrasound but non the less I am so afraid has anyone carrying twins had any bleeding and sucessfully carried both babies?

danamay3 - 1660 days ago.
I had Twin to Twin Transfusion 12 years ago with my twin girls, they were born by c-section at 25 1/2 weeks and they weighed 1 lb. 5 oz. and 1 lb. 12 oz, it was so scary!! They are now happy healthy preteens, you would never know that they were so fragile and sick once upon a time. My heart goes out to all the families that are having complications with their twins. I wanted to share my story to give mothers hope that miracles do happen.