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Pregnancy Symptoms with Twins: Double Trouble?

calendarJuly 26, 2016
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Pregnancy symptoms with twinsPregnancy Symptoms with Twins

If you know you are expecting twins, you may be wondering if the symptoms of twin pregnancy are any different than symptoms of a singleton pregnancy. In some cases, twin pregnancies can be more difficult because of the high elevations of HCG that create more nausea and vomiting  than in singleton pregnancies.

Certainly, breast tenderness can be more significant in the early stages of pregnancy with twins. It all depends on what the HCG levels are and on how a woman’s individual body responds to the HCG and elevated levels of progesterone in the system.

Pregnancy symptoms with twins can mean twice nausea and vomiting and more symptoms. It can also feel like a regular pregnancy with only an early ultrasound indicating that you have twins. Twins can be fraternal and will have two placentas, while, in identical twin pregnancies, they share the same placenta that just tends to be bigger and produce more hormones than a regular placenta with a singleton pregnancy.

Are Pregnancy Symptoms for Twins Tolerable?

Most women handle pregnancies with twins, especially in the first trimester (from the 1 st week till the 13 weeks of pregnancy) very well, and some don’t even know they are having twins. It’s only when the measurements of the uterus come out bigger than average that the doctor suspects twins and orders an ultrasound. An ultrasound at any stage of the pregnancy will show two embryos or two fetuses, and these will have to be assessed to a greater degree than a singleton pregnancy.

The woman is often growing much faster in the abdominal and pelvic area when there are twins, and she is often more tired, with more stretch marks when the pregnancy gets into the second trimester (from the 14 weeks till the 27 weeks of pregnancy). The woman is often growing much faster in the abdominal and pelvic area when there are twins, and she is often more tired, with more stretch marks when the pregnancy gets into the second trimester.

It is the second trimester when a woman with twins needs to be aware of things like an incompetent uterus and twin-twin transfusion symptoms, so this means more doctor visits and more careful observation. A twin pregnancy often has several ultrasounds to locate the position and growth of the fetuses. Nonstress tests and biophysical profiles are done in twin pregnancies to make sure both fetuses are growing properly and have no complications of not being alone in the uterus.

Are Symptoms of Pregnancy with Twins Dangerous?

Symptoms of a twin pregnancy are usually no more dangerous or serious when compared to singleton pregnancies. There may be an increased risk of nausea and vomiting in pregnancy but even with conditions like hyperemesis gravidarum or “excessive nausea and vomiting of pregnancy”, IV fluids can be given so that the woman doesn’t have to be dehydrated and can keep a normal electrolyte status in spite of the symptoms. 

When nausea and vomiting improve, and the woman can eat and drink without much nausea or vomiting, this means the twin pregnancy symptoms have settled down, and the woman can go on to have a normal twin pregnancy.

If the cervix is incompetent, it means that it attempts to open too soon and is more likely to happen in a twin pregnancy. This may mean an early bedrest situation or the placement of a cervical cerclage, which can keep the cervix closed until the delivery becomes imminent. These things aren’t required in the vast majority of twin pregnancies, but some women have a cervix that can’t tolerate such a rapid enlargement of uterine contents.

Will Symptoms of a Twin Pregnancy be Obvious?

It may not be obvious for quite some time that the woman has a twin pregnancy until an ultrasound is done or until the growth of the uterus seems to be in excess of what is expected for a singleton pregnancy. Sometimes the doctor will not be able to tell using a Doppler fetoscope alone in order to detect the presence of a twin pregnancy and it won’t be until a regular ultrasound is done before a twin pregnancy is established.

Many women have normal pregnancy symptoms in a twin pregnancy until the growth becomes excessive, and the twin pregnancy becomes more obvious. There will be things like fatigue, breast tenderness, changes in cervical mucus, nausea and vomiting in the first trimester that will not always give away the fact that there are two babies in the uterus, and it will be a big surprise when the woman has the official ultrasound revealing two babies growing inside her.

Twin pregnancies, in general, are riskier than singleton pregnancies, but most women go through this process quite easily and give birth vaginally or by cesarean section to healthy fraternal or identical twins. There is certainly more surveillance in a twin pregnancy even when symptoms are as expected but this is to make sure that the twins do not arrive too early or that one twin is outgrowing another in a twin-twin transfusion syndrome. Most twins are born healthy at near term or term and can go home with mom within a couple of days of birth.

Read also: Getting Pregnant with Twins: What Should You Know?

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