Twins and Triplets Can Make Pregnancy Complicated: Why Are They High-Risk?

What is a multiple pregnancy?

A multiple pregnancy or multiple gestation refers to a pregnancy with two or more fetuses. Multiples make up about 3% of births, according to the Centers for Disease Control.

Risk factors for a multiple pregnancy include genetics (a family history of twins), maternal age (after 30 your body may release multiple eggs at a time), and fertility treatments. Multiple embryo transfers as part of in vitro fertilization (IVF) treatment also have an increased risk of twins or higher-order multiples depending on the number of embryos.

While a singleton pregnancy can become high-risk, multiple gestation comes with a higher risk of complications. Because of this risk, expectant mothers should work with a high-risk OB/GYN. While your multiple birth may go off without a hitch, it’s good to have an expert in your corner in case complications arise.

Maternal-fetal medicine specialist Dr. Steve Rad and his highly-trained team can provide preconception counseling, prenatal care, and genetic counseling as well as providing care and help during labor, postpartum, and breastfeeding. It should be noted that most pregnant women who have proper care will give birth to a healthy baby.

Why is multiple gestation high risk?

The most significant twin pregnancy risk is preterm labor (delivery before 37 weeks). More than 60% of twins and almost all other multiples (triplets, quadruplets, etc.) are born prematurely.

Premature babies are born before their bodies and organs are fully developed and have low birth weights as a result. These preemie babies usually require time in the neonatal intensive care unit to help with breathing, eating, fighting infection, and keeping warm. Premature birth also increases the newborn’s risk of birth defects or congenital abnormalities.

About 25% of twin pregnancies are complicated by fetal growth restriction (FGR). In identical twins that share a placenta this can be caused by unequal distribution of blood and nutrients between the fetuses, twin-to-twin transfusion syndrome, or tangled umbilical cords. FGR can result in preterm birth, low birth weight, long-term medical complications, and even stillbirth.

Twins and other multiples are at a higher risk of miscarriage overall. Sometimes just one embryo will miscarry in the first trimester (with or without bleeding) leaving you with a healthy single pregnancy.

Is a multiple pregnancy dangerous?

Pregnancy is hard on the body. You’re carrying another living being inside your body and providing it with all the nutrients it needs to grow and develop. The strain on your body is understandably increased when you’re carrying and providing for multiple embryos. Health conditions that may arise during pregnancy become more likely

Twin pregnancy complications for mothers can include:

• Gestational hypertension: Carrying twins or other multiples increases your risk of developing high blood pressure during pregnancy.
• Gestational diabetes: A multiple pregnancy increases your risk of high blood sugar during pregnancy.
• Pre-eclampsia: A dangerous pregnancy complication consisting of high blood pressure, protein in urine, and potential organ damage, carrying multiples increases your risk of pre-eclampsia.
• Placental abruption: When carrying multiples, you’re at higher risk of placental abruption — the placenta detaching from the wall of the uterus.

Complications of twin pregnancies during delivery

The biggest risk of a multiple pregnancy is preterm delivery. Sometimes, labor must be induced early to mitigate other risks or problems. For example, some health problems that put you or your babies at risk (such as diabetes, high blood pressure, or placental abruption) can only be “treated” by giving birth.

Patients giving birth to multiple babies are also at increased risk of postpartum hemorrhage (although it’s still not very likely). Because this is a known risk, our obstetrics team will keep a close eye on you and follow up frequently after delivery to watch for bleeding or other complications.

Patients carrying multiple fetuses are more likely to need a Cesarean delivery (C-section). This can either be planned or performed as an emergency surgery if further complications arise during delivery.

Why trust your high-risk pregnancy to Dr. Rad

Dr. Steve Rad, MD, FACOG, is a highly specialized and international expert in obstetrics, gynecology, maternal-fetal medicine (perinatology), and high-risk pregnancies.

Dr. Rad’s highest priority as a healthcare provider is his patients and the care they receive. Dr. Rad recently had twin baby girls born prematurely due to his wife’s high-risk pregnancy. As a result, he has first-hand experience of what a high-risk pregnancy and NICU care entails.

Call us at (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.

We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.