Why Specialised Care Matters in Twin and Multiple Pregnancies?
Finding out that you’re expecting twins, triplets, or even more can feel like stepping into a whole new world. Along with double the joy, come new questions, concerns, and decisions about the kind of care you and your babies will need.
Twin and multiple pregnancies need a little extra attention. Not because they are always complicated, but because having more than one baby means your body is working harder and your babies share a unique space. This is where specialised care makes a difference.
Understanding Your Type of Twins or Multiples: Whether your babies share a placenta or sac can influence how often you’re monitored and how your pregnancy is managed. Specialised clinics help you understand this clearly and guide you accordingly.
More Careful Monitoring: With twins or more, your pregnancy may require more frequent check-ups and detailed scans. These help your care team keep track of each baby’s growth, your health, and any signs that need quick attention. These detailed scans help experts track blood flow, check placenta and amniotic fluid levels, and spot early signs of conditions like Twin-to-Twin Transfusion Syndrome (TTTS).
Timely Support for Medical Needs: Multiple pregnancies have a higher chance of concerns like anaemia, high blood pressure, preterm birth, and increased physical discomfort. Having a skilled team makes it easier to manage symptoms early and safely.
Twins, more so -twins that share a placenta have some unique complications that demand special attention.
Twins are more likely to arrive early. Signs like preterm contractions, water breaking, or unusual pressure are important to report immediately. Specialised care helps prepare you for early birth and ensures neonatal support is ready.
2. TTTS (Twin-to-Twin Transfusion Syndrome)
TTTS occurs only in identical (monochorionic) twins who share a placenta. In TTTS, the shared placenta gives unequal blood supply to the babies. One twin (the donor twin) gives too much blood to the other and the other twin (the recipient twin) receives too much blood. This imbalance can affect the growth and well-being of both twins.
Some common signs doctors look for are:
Difference in amniotic fluid levels around the babies
One baby appearing smaller
One baby’s bladder not filling well
Rapid or slow growth in either baby
TTTS can progress quickly. Regular scans help catch it at the earliest stage, when medical teams can step in with treatments like laser therapy or careful monitoring, depending on the severity.
3. Twin Anaemia–Polycythaemia Sequence (TAPS)
TAPS can occur with or without TTTS in monochorionic twins. Here, small blood vessel connections in the placenta cause one twin to become anaemic (low red blood cells) and the other to have too many red blood cells (polycythaemia). It may not cause big changes in amniotic fluid, which is why expert Doppler scans are essential for diagnosis.
4. Selective Fetal Growth Restriction (sFGR)
sFGR happens when one baby receives less blood flow or has a smaller share of the placenta, making them grow more slowly. A significant size difference between the babies and differences in blood flow to the smaller twin are some of the signs. Specialised monitoring helps decide the safest time and mode of birth.
A rare condition where one twin (the “pump twin”) provides blood to the other non-developing twin, causing extra strain on the pump twin’s heart. With early detection, specialists can perform procedures to protect the healthy twin.
6. Cord Entanglement (in MoMo Twins)
In monoamniotic twins (babies sharing the same amniotic sac), the umbilical cords can become tangled, affecting blood flow. These pregnancies need very close monitoring, often with more frequent scans and hospital-based monitoring in the third trimester.
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