Multiples: Risks to the Mother

Most doctors categorize multiple pregnancies as “high risk" and will monitor such patients carefully. While there are numerous risks to the babies, the mother carrying multiples faces many obstacles as well.

Gestational Diabetes

Women carrying multiples are more than twice as likely to experience gestational diabetes. This is attributed to the fact that the increase in hormones produced by the extra babies interferes with the body's ability to process insulin. Often, it can be controlled with diet, but sometimes medication is needed.

The Placenta

Mothers of multiples are at greater risk of experiencing problems associated with the placenta. This round flat organ is considered the “lifeline” and transports nutrients and oxygen from the mother to the fetus. During a normal pregnancy, the placenta is firmly attached to the inner wall of the uterus until the baby is born. Placenta previa is a condition where the placenta lies unusually low in the uterus next to or covering the cervix. If it persists later into the pregnancy it can cause bleeding, premature delivery and other complications.

Placenta abruptio is the early separation of the placenta from the uterus. An abruption can be life-threatening for the fetus, and sometimes for the mother as well. It can lead to preterm birth, low birth weight, and major maternal blood loss. In rare cases, severe placenta abruptio can lead to fetal or newborn death. However, careful monitoring can detect most problems before they pose this serious risk.

C Sections

While many twins are delivered vaginally, there is still a greater chance of having to deliver via cesarean section. With higher order multiples it is almost always recommended.

Blood Pressure and Heart Problems

Preeclampsia and PIH (Pregnancy-Induced Hypertension) are blood pressure problems that can affect all pregnant women, but mothers of multiples are at a much higher risk of experiencing such complications. Blood volume increases during pregnancy, and multiple babies can heighten this reaction. Treatment includes restricting activity, bed rest and sometimes medication. Severe cases may require early delivery of the babies.

Some recent studies suggest that women who carry two or more fetuses are more likely to experience heart problems. This is due to the increase of physiological stress, since each additional fetus raises the level of cardiac output.

It is important to be aware of the many risks associated with a multiple pregnancy. Careful monitoring and early diagnosis of these potential conditions are the best way to ensure a healthy pregnancy.