Seeing Double: Webinar on Twins

In recent years, the incidence of twins (or higher order multiples) has increased in the United States due to many factors some of which include: increased use of assisted reproductive technology (ART) such as IVF and ovulation enhancers like, Clomid. Also, women are choosing to start families later in life. This increased maternal age increases the incidence of multi-ovulation cycles, in turn increasing the incidence of twins.

I wanted to gain some more knowledge about twinning and capture a few take-home points for my readers, so I found a webinar that gave some helpful information about twins, that I wanted to pass along.

Women who are pregnant with twins need to eat 300 more kcal than women pregnant with singletons. That means increasing your normal diet by 600 kcal. More important than calories alone, is the vitamins and minerals that you take. Doctors recommend getting 1mg of folate and 60mg of iron after the first trimester. Also, many care providers suggest increasing the amount of protein that you eat, which has been shown in to possibly decrease the incidence of pre-eclampsia. Click here to read more about diet and pre-eclampsia.

How do you know what type of twin you are having?

Most twins are dizygous, meaning they were formed from two eggs and two sperms. They typically have two placentas (dichorionic) and two amniotic sacs (diamniotic). These twins are called "fraternal".

"Identical" twins or monozygous twins are formed with one egg and one sperm that later split into two. Although identical twins can have one or two placentas, one or two amniotic sacs or be conjoined, the most common situation is one placenta (monochorionic) and two amnotic sacs (diamniotic).

                                  (most common)

So what does all this mean in practical terms?

ACOG (American College of Obstetrics and Gynecology) has set some standards on when these type of twins should be born. If you are having babies that have two placentas (dichorionic), they should be born between 38-39 weeks. However, if you are having twins with one placenta (monochorionic), ACOG recommend delivery between 34-38 weeks. 

What is the likelihood that you will deliver vaginally?

As long as there are no other twin-type complications, 43% of twins present both head down, which would allow for a vaginal birth. The second most common presentation is 1st baby head down and 2nd baby "other" (breech or transverse). This presentation also usually allows for a vaginal delivery.

After all that information are you seeing double? I know I am! I hope this information was helpful. For more in-depth knowledge, check out the webinar linked above.