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What special care is needed in a multiple pregnancy?

Women who are expecting multiples generally need to visit their health care providers more frequently than women expecting one baby. These extra visits can help prevent, detect and treat the complications that develop more often in a multiple pregnancy. Health care providers may recommend twice-monthly visits during the second trimester and weekly (or more frequent) visits during the third trimester.

Starting around the 20th week of pregnancy, a health care provider monitors the pregnant woman carefully for signs of preterm labor. The provider may do an internal exam or recommend a vaginal ultrasound to see if the woman's cervix is shortening (a possible sign that labor may begin soon).

Even if a woman pregnant with multiples has no signs of preterm labor, her provider may recommend cutting back on activities sometime between the 20th and 24th weeks of pregnancy. She may be advised to reduce her activities even sooner and to rest several times a day if she is expecting more than two babies.

As a multiple gestation progresses, the health care provider regularly checks the pregnant woman's blood pressure for preeclampsia. The provider also may recommend regular ultrasounds starting around 20 weeks of pregnancy to check that all babies are growing at about the same rate.

During the third trimester, the provider may recommend tests of fetal well-being. These include:

  • The non-stress test, which measures fetal heart rate when the baby is moving
  • The biophysical profile, which combines the non-stress test with an ultrasound

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