A multiple gestation is a gestation where there are more than one fetuses. It is a fact that over the last 20 years, multiple gestations showed an impressive rise
The special facts about multiple fetuses, have been studied intensively. Ιn an effort to identify the effects of genetic and environmental factors, before and after the labor. The most cases anyway, are about twin pregnancies.
The observation of a twin pregnancy is actually the same as a single pregnancy’s, during the first months. Later, it is similar to a high-risk pregnancy observation, and it is dealt with as such.
Twin fetuses can be identical, meaning from the fertilization of one egg, or fraternal, meaning from the fertilization of two different eggs. An identical twin pregnancy means that the embryos are genetically the same. On the other hand, a fraternal twin pregnancy mean that the embryos are different.
The frequency of fraternal twin pregnancies varies according to the race, the mother’s age, the number of deliveries and the possibility of in vitro fertilization. In fact, the frequency of identical twin pregnancy could be related to a great degree to IVF.
It is clear that early diagnosis of a multiple pregnancy is vital to its right observation and evolution. Before the vast use of ultrasonography, a great number of twin pregnancies could not be diagnosed, until the time that the labor was imminent.
The decision about the kind of delivery depends many times according to the shape and presentation of the fetuses. The commonest presentation is cephalic/cephalic (50%), followed by cephalic/breech (25%), breech/cephalic (10%) and breech/breech (10%). 5% is a combination.
The indications for cesarean section for the twin pregnancy are usually the ones that exist for a single pregnancy. Although, most of the times we prefer a cesarean section.
This decision depends on many factors, such as the gestational week, the situation of the fetuses, the integrity of the membranes, the signs of possible infection or hemorrhage, the number of deliveries and the positions of the fetuses.
A woman with the previous problems of health clearly has the right to become a mother. Definite, with the help of a proper observation from her gynecologist, she can enjoy motherhood like everybody else!