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
- Advise the woman to look for signs of
- Antenatal parent education
- Any available support services for twin pregnancies
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