Multiple Pregnancy 

When a woman is carrying more than one baby at once, it’s known as a multiple pregnancy.  

A multiple pregnancy (sometimes referred to as a multiple birth) occurs when a woman is carrying more than one baby at one time. For example, when a woman is pregnant with twins (two babies) or triplets (three babies), it’s known as a multiple pregnancy. And when a woman is carrying more than three babies—such as quadruplets (four babies) or quintuplets (five babies)—it’s referred to as a high-order multiple pregnancy. 

Although being pregnant with more than one child can certainly be something to celebrate, it doesn’t come without its risks. When compared to a singleton pregnancy (one where the woman is carrying only one baby), a multiple pregnancy presents a higher risk of complications such as: 

• Fetal growth restriction 
• Gestational diabetes 
• Gestational hypertension (high blood pressure) 
• Placenta abruption 
• Postpartum depression 
• Preeclampsia 
• Premature labor and birth 
• Selective intrauterine growth restriction (sIUGR) 
• Twin-anemia-polycythemia sequence (TAPS) 
• Twin-reversed-arterial-perfusion syndrome 
• Twin-twin-transfusion syndrome (TTTS) 

Causes of a Multiple Pregnancy 

Multiple pregnancies can occur in two different ways: 

• Identical – When sperm fertilizes one egg and then the egg splits before implanting in the lining of the uterus, it produces identical siblings who look the same and are the same sex. 
• Fraternal – When different sperm fertilize more than one egg at the same time, and then those eggs each implant in the uterine lining, it produces fraternal siblings who look different and may be different sexes (although they can be the same sex). 

There are a number of risk factors that can increase the likelihood of having a multiple pregnancy, including: 

• Being over the age of 30 
• Being taller or heavier than average 
• Using fertility treatments 
• Having a family history of multiple pregnancies 

Symptoms of a Multiple Pregnancy 

When compared to singleton pregnancies, multiple pregnancies tend to produce: 

• Increased soreness and tenderness in the breasts 
• Worsened nausea and vomiting (morning sickness) 
• Greater hunger 
• Faster weight gain during the first trimester 
• Higher human chorionic gonadotropin (hCG) and alpha-fetoprotein levels

Diagnosing a Multiple Pregnancy 

Physicians generally diagnose multiple pregnancies using ultrasounds, which provide images of the inside of the mother’s uterus. They can also use blood tests to measure hCG and alpha-fetoprotein levels. 

Treatment for a Multiple Pregnancy 

Unless a multiple pregnancy causes complications, it generally won’t require any special treatment. However, the physicians at Tampa General Hospital will likely want to closely monitor a multiple pregnancy to ensure that the mother and the babies remain as healthy as possible. This may require having ultrasound examinations on a more frequent basis than would be required for a singleton pregnancy.