Antenatal care in twin pregnancy
  • Physical demands of multiple pregnancy can be very tiring for the woman. Common discomforts of pregnancy may be increased
  • Multiple pregnancies need close monitoring — refer to obstetrician as soon as multiple pregnancy identified and do obstetrician/doctor/midwife consult at every appointment. Consider telehealth
  • Birth of twins often complicated — always plan for hospital birth at major hospital with maternal and newborn services

Table 2.4   Increased risks of complications for mother and baby

Talk with woman about

Antenatal care schedule

Explain schedule to woman so she can understand and be involved 

  • Extra visits will be needed as advised by obstetrician
  • See Antenatal care for what to do at visits

Obstetrician will help plan antenatal care and obstetric ultrasounds

  • Early first trimester ultrasound to confirm gestation, number of babies and placentas
  • Ultrasound at 16–18 weeks THEN
    • Every 4–5 weeks if 2 placentas (dichorionic diamniotic — DiDi twins) 
    • OR every 2 weeks if 1 placenta (monochorionic diamniotic) — MoDi OR (monochorionic monoamniotic) — MoMo twins — high risk of twin-to-twin transfusion syndrome with 1 shared placenta
  • Make plans for woman to birth in hospital — talk with woman about options for birthing. Woman will need to go to a major birth centre earlier than for a singleton pregnancy

Supporting resources