Complications you may face when you have a multiples pregnancy

Preterm labor is when labor starts prior to 37 completed weeks of pregnancy. This determination of weeks actually decreases with each additional baby a woman with multiples is pregnant with. Women who are pregnant with one baby are typically expected to be full term around 38 weeks to 42 weeks of pregnancy. A woman pregnant with twins is expected to reach 36 weeks, if she is pregnant with triplets - 32 weeks, quadruplets - 30 weeks and quintuplets 29 weeks.

Did you know that approximately 60% of twin pregnancies are delivered prematurely and 90% of triplet pregnancies end in preterm labor? The majority of higher multiples end in preterm labor. Most of the time premature labor is the result of preterm premature rupture of membranes (PPROM) prior to going into labor for a woman who is less than 37 weeks pregnant.

Low birth weight is usually a result of malnutrition, preterm labor, infection or abuse of alcohol or other street drugs. A low birth newborn is determined by being less than 2,500 grams or less than 5.5 pounds. If the baby is born prior to 32 weeks and is less than 1,500 grams or 3.3 pounds the baby is considered severely premature and is at higher risk for developing complications such as breathing and feeding problems, infections and developmental delays. They are also at future risk for developing long-term issues such as cerebral palsy, hearing loss, mental retardation and also vision loss.

Multiples are at risk for intrauterine growth restriction (IUGR), which is the result of the placenta having difficulty supporting so many babies. The growth of the babies slows down typically twins slow at 32 weeks, triplets slow at 28 weeks, and quadruplet pregnancies and higher can see slowed grow by the 25th week of pregnancy. Multiple pregnancies typically receive lots of ultrasound scans to monitor the health and growth of the babies.

Preeclampsia occurs often in multiples. Proper prenatal care can decrease the risk for preeclampsia or at least minimize serious complications from preeclampsia, which can be fatal to both mom and babies.

Gestational diabetes is quite common in multiples because of the placental issues caused by so many babies (more than one placenta, increased placental size and elevated placental hormones). These placental issues increase the resistance to insulin, which leads to gestational diabetes.

Placental abruption increases three-fold with multiples and can occur in the third trimester.

Fetal loss is uncommon especially as multiples are so closely monitored by the medical professionals caring for multiples pregnancy. Often times during a multiples pregnancy the risk for early delivery has to be weighted against having the babies remaining in utero.

A cesarean birth is usually the case with pregnancies higher than twins. Twin pregnancies will deliver vaginally if the presentation of both babies shows that delivery will be low risk. A vaginal birth is possible for twins if the gestation of the twins is greater than 32 weeks, twin A is closest to the cervix and is the largest baby, twin A is head down, and twin B is head down, breech or sideways and also there is no sign whatsoever of fetal distress in either twin and also if there is no cephalopelvic disproportion (CPD). CPD is when a baby's head, or body is too big to fit through the pelvis. If CPD is diagnosed the safest delivery method is cesarean.