Detailed process of prenatal checkup for twins

If you want to check the development of the fetus in your belly and whether you are having twins, it is best to use B-ultrasound, because B-ultrasound can well reflect the development of the fetus in the uterus. A twin pregnancy requires more nutrients than a single fetus, which results in twins not weighing as much as a single fetus. Twins also have higher requirements for the mother. I hope mothers should do more examinations and respond to the fetal condition in a timely manner.

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1. The prenatal checkups required for single-baby pregnancies also need to be done for twin pregnancies. Routine checkups during pregnancy include: maternal height and weight/body mass index (BMI), basic blood pressure measurement, oral examination, heart, lung, liver and kidney function examination, uterine height and abdominal circumference measurement, vaginal and cervical examination, blood routine, urine routine, gestational diabetes test, sexually transmitted disease screening, fetal heart rate monitoring, fetal position monitoring, placental maturity

2. Compared with the prenatal check-up items for single-baby pregnancies, the prenatal check-up for twin pregnancies should also try to confirm whether the twins are identical twins or fraternal twins. The presence of twins is confirmed on the premise of confirming intrauterine pregnancy. As early as 6 weeks of pregnancy, two gestational sacs can be found through B-ultrasound examination. At 7 weeks of pregnancy, two primitive cardiac arteries can be seen. At 13 weeks of pregnancy, B-ultrasound can clearly show the two fetal head halos and their respective spines, trunks, limbs, etc.

3. Determine whether they are fraternal twins or identical twins. Fraternal twins refer to two fertilized eggs, each with an independent placenta and gestational sac, with no blood circulation between the two, and they develop independently. Identical twins refer to two fertilized eggs that share one placenta and gestational sac, with blood communication between the two. If there is a difference in blood pressure between the arteries and veins, it may cause twin-twin transfusion syndrome. Therefore, identical twins are at greater risk and require close monitoring and more testing than normal fraternal twins.

4. Confirm the survival of both fetuses. If one of the fetuses is found to be dead during the early or mid-pregnancy check-up, there is no need to worry, as the other fetus will continue to grow and the dead fetus will usually be absorbed and disappear. If one of the fetuses is found to be dead in the late pregnancy, the pregnancy should be terminated as soon as possible to prevent the dead fetus from releasing thromboplastin and causing disseminated intravascular coagulation. If the twins are fraternal twins, low-dose heparin can be used for treatment.

Greater risk

The risks of general non-invasive routine prenatal examinations are not high. The risks during prenatal examinations mainly lie in the traumatic invasive examinations, especially invasive prenatal examinations for twins. The risks are mainly reflected in the following aspects:

1. Twin Down syndrome screening

Currently, the data on Down syndrome screening is only based on people with single-baby pregnancies. Down syndrome screening cannot be performed on twin pregnancies. If the pregnant woman has high-risk factors, she will have to undergo amniocentesis or umbilical cord blood puncture to obtain a diagnosis, and specimens must be obtained from both amniotic cavities. As invasive examinations, amniocentesis or umbilical cord blood puncture inevitably carries risks such as infection, miscarriage, and amniotic fluid embolism. When performing prenatal examinations on twins, there are even more uncertainties and risks. When it is determined that the risk is high or a procedure such as amniocentesis is needed, careful consideration should be given based on one's own situation and the development of the fetus, and it is best to avoid invasive examinations. In addition, you should avoid labor and bathing for 24 hours after the operation and keep the wound dry. If you experience persistent abdominal pain, bleeding, water breaking or any discomfort, you should seek medical attention immediately.

2. Twin births

Due to their complexity, twin pregnancies pose greater risks during labor and delivery. At this time, prenatal examinations should pay close attention to fetal heart rate monitoring and fetal position. Because twins are more likely to have malpositions and after the first fetus is born, the second fetus is likely to turn into a transverse position due to its increased range of motion, and due to sudden changes in the uterus, early placental abruption is likely to occur, threatening the life of the second fetus. Or the two fetal heads may cross each other and enter the pelvis at the same time, causing dystocia. Measures: Any slight negligence during prenatal checkup of twins may result in fatal problems. Pregnant women must monitor their fetus in real time and count the number of fetal movements themselves. If there are any abnormalities or signs of labor such as water breaking, spotting, etc., you should seek medical attention immediately and prepare for infusion, blood transfusion and fetal rescue.