Complications of Twin Pregnancy

Healthy multiples are born every day. Still, it's important to be aware of possible complications. For example:

• High blood pressure. Mothers of multiples are more likely to develop high blood pressure during pregnancy. When high blood pressure is combined with protein in the urine, the condition is known as preeclampsia. Careful management is needed to prevent serious complications for both mother and baby.
• Premature birth. The more babies you're carrying, the less likely you are to carry your pregnancy to term. If you have signs of preterm labor, you might be given injections of a steroid medication to speed your babies' lung development. Even then, however, the smallest preemies might fight to survive. Complications might include low birth weight, breathing and digestive difficulties, and underdeveloped organs. Rarely, one baby is delivered prematurely and the other baby or babies are able to continue developing in the uterus. This is known as a delayed-interval delivery.
• Twin-twin transfusion. With identical twins, it's possible for a blood vessel in the placenta to connect the babies' circulatory systems. This causes one baby to receive too much blood and the other too little. This is a serious complication for both babies that might require aggressive intervention during pregnancy. Often, babies in this situation are delivered as soon as the benefits of early birth outweigh the potential problems of prematurity.
• C-section delivery. For twins, vaginal delivery is often possible if the first baby is in a head-down position. If not, a C-section might be recommended. In some cases, complications after the vaginal delivery of the first twin might require a C-section delivery for the second twin. For triplets, vaginal delivery isn't necessarily out of the question — although C-sections are generally suggested for triplets and higher order multiples.