Multiple Pregnancy.

A multiple pregnancy almost always surprises expectant parents. However, because of today's advanced testing techniques, especially ultrasound, most parents know about it early enough to prepare for their new arrivals.

The rate of multiple births increased between 1980 and 1992; today 1.5% of all births are multiple births. This increase is due to the use of fertility drugs and more women having babies at an older age.

A multiple pregnancy occurs when a single egg divides after fertilization or when more than one egg is fertilized. It also happens with fertility treatments, when more than one fertilized egg is placed in the uterus. Twins from one egg, called identical or monozygotic twins, occur about once in every 250 births around the world. Twins from two eggs, called fraternal or dizygotic twins, occur in 1 out of every 100 births in white women and 1 out of 79 births in black women. In certain areas in Africa, twins occur once in every 20 births! Hispanic women also have a higher incidence of twins. The occurrence of twins in Asian populations is less common-about 1 in every 1 50 births.

Today, we are also experiencing more triplet births. However, a triplet birth is not common. It happens about once in every 8,000 deliveries.

Reasons Multiple Births Occur
The increase in multiple births among older women has been attributed to higher levels of gonadotropin, the hormone that stimulates the ovaries to develop and to release eggs. As a woman ages, the level of gonadotropin increases, and she is more likely to produce two eggs during one menstrual cycle. Most twin births in older women are fraternal twins (babies born from two different eggs).

The incidence of twin births can run in families, on the mother's side. One study showed that if a woman is a twin, her chance of giving birth to twins is about 1 in 58. If a woman is the daughter of a twin, she also has a higher chance of having twins. Another study reported that lout of 24 (4%) twins' mothers was also a twin, but only lout of 60 (1.7%, about the national average) of the fathers was a twin.
Multiple births are also more common with in-vitro fertilization.

This may be due to the frequent use of fertility drugs to increase the chance of pregnancy or the introduction of several fertilized eggs in hopes that at least one will implant.

Signs Of A Multiple Pregnancy
Most multiple pregnancies are discovered well before delivery. A doctor usually finds out a woman is carrying more than one baby because of various signs, including a larger-than-expected uterus, more severe nausea and vomiting, and more than one fetal heartbeat. When a doctor suspects a woman is carrying more than one baby, an ultrasound is usually ordered. An ultrasound exam almost always detects a multiple pregnancy.

Increased Risks Associated With A Multiple Pregnancy
If a woman is pregnant with more than one baby, her risk of problems during pregnancy increases. You can minimize risks, and possibly avoid them, with good prenatal care and careful attention to your health. Possible pregnancy problems include the following:

•    increased risk of miscarriage
•    fetal death
•    fetal malformations low birth weight or growth restriction
•    pre-eclampsia
•    maternal anemia
•    problems with the placenta
•    maternal bleeding or hemorrhage
•    problems with the umbilical cords
•    hydramnios or polyhydramnios
•    labor complicated by breech or transverse presentation
•    premature labor

If you're pregnant with more than one baby, take good care of yourself during pregnancy. Pay strict attention to your eating plan; eat wisely and nutritiously for all of you. Extra rest is essential. Most pregnant women need at least 2 hours of extra rest each day.
When you're pregnant with more than one baby, you are monitored more closely during pregnancy. You will probably have more frequent checkups and more tests.

Beginning in your 20th week, you will probably visit your doctor every other week until the 30th week. Then you may be seen once a week until delivery. You may have ultrasound more frequently to monitor the babies' growth. Your blood pressure is monitored closely because of pre-eclampsia, which is twice as common in multiple pregnancies.