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Preparing for multiples

Twins are twice the fun, twice the work, and twice the joy! Twins also are more likely to have IUGR.

Congratulations on your twins (or more)! Multiples are great fun, but they are more likely to have health problems such as IUGR. While most pregnancies of twins and triplets or more can be healthy, the babies are more likely to be crowded when there is more than one.

Multiples are more likely to have IUGR.

There are several reasons that multiples are more likely to have IUGR. First, physical crowding in the womb limits the growth of the babies. Second, if babies share a placenta (called monochorionic, diamniotic twins), sometimes one twin gets the greater portion of blood and thus nutrition and oxygen from the mom. This leaves the other twin with a lesser portion, and possibly not enough nutrition and oxygen for normal growth. In severe cases, this unequal sharing of blood flow is called twin-to-twin transfusion syndrome (TTTS).

TTTS occurs both when twins share a placenta and get unequal blood flow from the placenta and when both babies are affected by the unequal sharing of blood flow. TTTS results in one baby having insufficient nutrition for growth, and is called the donor twin, and the other twin having to work hard to handle the extra blood flow, called the recipient twin. Some hospitals will offer laser surgery to correct the blood flow between the twins to allow both twins to receive a healthy amount of blood from the placenta. You should talk to your doctor about the risks and benefits of getting surgery for TTTS.

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