12 Health Complications Observed During Twin Pregnancy

Parents always fantasize about welcoming their babies into the world. It brings a sense of inquisitiveness and leaves them wondering how their lives are going to change soon. The ambivalence of excitement and concerns manifolds when they discover that not one, but two infants are to arrive. Apart from celebrations and anticipations,  parents need to take special care, considering the complexities that come along with twin pregnancy. Certain possible complications may require special medical attention, but most of them can be diagnosed and addressed with timely checkups.

Here are 12 complications that the parents might have to face in the course of twin pregnancy.


1. Premature Delivery


A normal pregnancy spans 40 weeks, whereas a premature labor occurs before 37 weeks of the gestation period. The chances of premature delivery increases if a woman is carrying twins. Normally, twin pregnancies last for 36 weeks. The longer the baby stays inside the womb, better the chances they will be born healthy. Premature births can lead to health problems due to which the babies are kept under observation in neonatal intensive care units (NICU).


2. Low Birth Weight

A normal body weight for a newborn ranges from 5.5 to 7 pounds. Twin infants almost always weigh around 5.5 pounds each. Babies below that mark are considered to have lower birth weight and therefore, need to be kept in the NICU. When in the womb, the twins compete for nourishment. This slows down their growth in the 8th month of pregnancy. Though most preemies catch up with the weight while under NICU care, it is important to monitor their growth throughout the pregnancy.

3. Pre-eclampsia



Preeclampsia, a condition that occurs during pregnancy, is characterized by high blood pressure, proteins in urine, and fluid retention. Though it affects only 5-8% of pregnancies, the possibilities are higher in multiple pregnancies. A high blood pressure may not necessarily be pre-eclampsia. The severity of the condition can be determined by secondary symptoms, such as headaches, blurred vision, inability to tolerate bright light, fatigue, nausea, urinating small amounts, pain in the upper right abdomen, shortness of breath, and tendency to bruise easily.

4. Intrauterine Growth Restriction (IUGR)



The fetal growth in twins stops at 30 to 32 weeks of pregnancy. This is because as your babies grow, they compete for nutrients. The placenta at one point can no longer handle the growth sufficiently for both the babies. This hinders the normal growth of infants and puts them at a risk of health complications during pregnancy or post birth. IUGR can either strike if the mother’s weight is below 100 pounds or if she is malnourished during pregnancy.

5. Gestational Diabetes



Gestational diabetes occurs as a result of glucose or carbohydrate intolerance during pregnancy. This happens when the body is not able to produce adequate insulin to break down the sugar in the body. Symptoms include:

  • Unusual thirst
  • Frequent urination
  • Fatigue
  • Nausea
  • Frequent vaginal, bladder, and skin infections
  • Blurred vision

Doctors usually check your blood sugar levels between the 24th and 28th week of pregnancy. There are only 2-5% chances of developing gestational diabetes during pregnancy. The risks are higher if the mother is over 35, overweight or has a family history of diabetes.


6. Placental Abruptions


It is defined as the separation of the placenta from the uterine wall. The placenta is the life support system of your baby. Placental abruptions lead to disrupted supply of oxygen and nutrients to the fetus. The gynecologist must be immediately informed of any vaginal bleeding happening in the third trimester, as the condition can occur anytime after the 20th week of pregnancy.  If you experience any of the below symptoms, you should immediately contact your pregnancy health expert.


If you experience any of the below symptoms, you should immediately contact your pregnancy health expert.

  • Rapid contractions
  • Uterine tenderness
  • Abdominal pain
  • Fetal heart rate abnormalities
  • Vaginal bleeding in few cases

Mothers carrying twins are at a high risk of dealing with this condition. The good news is that only 1% of all pregnant women suffer from this condition. Most of them can be treated successfully depending on the type of the placenta separation.

7. Cord Entanglement


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The umbilical cord is the lifeline of the fetus. It connects the fetus to the placenta to exchange blood and nutrients. Cord entanglement can cause the umbilical cord to bend, disrupting the flow of the essentials to one or both the babies, leading to the retarded development or even death. This condition is more likely to occur in identical twins as they share the same amniotic sac as well as the same placenta. Identical twins can be ascertained through ultrasounds done before the 14th week of pregnancy. The distinguishable presence of a single placenta and the amniotic sac can infer the presence of identical twins.

8.Twin Transfusion Syndrome


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In few cases, in twin pregnancies, one of the twins can put both of them at risk. Twin transfusion happens when one fetus starts pumping large amounts of blood to the other. Though exchange of blood between twins is common, a considerable amount can cause the baby at the receiving end to develop heart failure, while the donor baby can develop anemia. A regular checkup can help diagnose the condition at an early stage and complications can be avoided with proper medical care.

9. Birth Defects


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Birth defects are commonly seen in multiple pregnancies. Around 10% of identical twins are born with defects, such as a dislocated hip joint, a heart problem or even a shortened limb. This can be imputed to the reduced room size for each twin to be accommodated within the womb. With early diagnosis and proper treatment, most of these defects can be treated completely.

10. Unequal Size


Twins never have an equal share. This variation may be in the supply of nourishment or space. While 30% of twins develop considerable differences in size, studies show that if one the babies weighs 25% more than the other, one or both might develop health complications and would require neonatal care.

11. Caesarian


Normally, 40% twins are delivered vaginally. The labor can get difficult for the mother, either due to a narrow birth canal or if the babies are in breech position (when instead of the head, the baby’s bottom faces the birth canal at the time of delivery). In such cases, caesarian, widely known as c-section is carried out to deliver the babies.

12. Fetal Loss


Despite timely intervention by the specialist, a loss of one of both babies may occur. The reasons could be multiple, but may not be definite. Premature births are one of the main causes of still-births. In such cases, family and hospital staff prove supportive, though nothing can fathom the loss that parents go through.

Having twins is a blessing as well as a challenge. You might even have to pay very frequent visits to your doctor. It may also require special attention from the experts if any complications arise. Good nutrition and quality prenatal care are prime requirements during gestation. The experience of having twins only adds on to the grandness, now you have not one but two babies flourishing inside you.