Multiple Births Quiz

According to the March of Dimes, about a third of the increase in multiple births can be explained by an increasing number of women older than age 30 having children. The remaining two-thirds of the increase can be tied to an increase in the use of fertility drugs and reproductive technology such as in vitro fertilization (IVF). Doctors now closely monitor women who are undergoing fertility treatment so that fewer babies will be produced. Women who have a family history of twins are more likely to have twins of their own. Women who are obese are also at higher risk for having twins.

These days, twins and other multiples are rarely a surprise at birth. Most multiple births are discovered with an ultrasound given near the end of the first trimester. A blood test done around the 16th week of pregnancy to help identify infants at increased risk for certain birth defects also can tell your health care provider that you may be carrying two or more babies. Your health care provider also may hear more than one fetal heart beating during an exam. Other symptoms of multiple births include more rapid weight gain than expected in the first trimester; a larger uterus than expected; and severe morning sickness.

The average gestation for triplets is 32 weeks; for quadruplets, 30 weeks; and quintuplets, 29 weeks, according to the March of Dimes. More than 90 percent of triplets are born preterm, and nearly all quadruplets are born preterm.

Premature infants also may have respiratory problems because their lungs have not fully developed. The closer an infant is to its due date, the less likely the child is to have health problems. Some of the health problems may be long term: mental retardation, and vision and hearing loss, according to the March of Dimes.

Identical twins begin as one fertilized egg that divides in half. The other two-thirds of twins are fraternal; they are formed from two separate eggs fertilized by two different sperm. Fraternal twins are no different from other siblings in the family, according to the March of Dimes. Identical twins look alike, are always the same sex and have the same hair and eye color. Fraternal twins often look different, even when they are the same sex; they have a greater variation in size than identical twins, both at birth and as they grow and develop.

Preeclampsia is high blood pressure that develops during pregnancy. Gestational diabetes is a form of diabetes that develops during pregnancy. These health problems can be treated. That's why prenatal care is critical for any woman who is pregnant.

These figures are for a woman of normal weight. A woman who is expecting triplets should gain 50 to 60 pounds. (In comparison, a woman expecting one child usually is advised to gain 25 to 35 pounds.) Your doctor can make recommendations for you based on your weight and health. A pregnant woman usually needs to eat an additional 300 calories a day; a woman carrying multiples will need even more calories.

Discuss with your doctor any special nutritional needs you may have. In general, a woman carrying multiples should take a prenatal vitamin that contains at least 30 mg of iron to prevent anemia and reduce the risk for pre-term delivery. A woman carrying multiples also needs adequate protein, as well as plenty of fluids.

Bed rest usually takes place in a hospital, and medications to halt premature labor may be given, as well. If labor does not halt and the infants are likely to be born before 34 weeks, the mother may be given corticosteroids, according to the March of Dimes. Corticosteroids encourage earlier development of the babies' lungs. Respiratory problems are common among multiples (and single children) who are frequently born pre-term.

A normal vaginal birth is likely if both babies are positioned with their heads down. Births of three or more infants usually require a cesarean delivery, because it is safer. A multiple of three or more means a crowded uterus, in which the placenta or umbilical cords may be compressed during labor. A cesarean also may be necessary if any of the babies is in a breech position (feet or buttocks down) or transverse lie (sideways).