Two smiles at once for mom, Life gave two worries,Two Fates, Double Exam, Two Hopes, Two Wings The news of pregnancy is one of the most memorable events in the life of every woman. And imagine the reaction of a woman who finds out that she is pregnant with twins? It would seem that a woman should experience double the joy. However, often parents experience completely opposite feelings: confusion, fear, discouragement. These feelings should not be embarrassed at all - this is an absolutely normal reaction of any sane person to the news that he will be given double responsibility. Very soon you will get used to this fact and accept it. After that, you will experience exactly the same feelings as all parents expecting the birth of one child. However, a twin pregnancy has its own characteristics, which distinguish it from a normal pregnancy. In this article, we have specially described for you the pregnancy by weeks with twins, as well as the characteristics of a twin pregnancy and the reasons for its occurrence. Having detailed information about what is happening to her and her body at all stages of pregnancy, the expectant mother will feel much more confident and calm.
What is the multiple pregnancy?
People often hear the words "twins" and"twins", but few people know the difference between these terms. The first thing to do is to understand the difference. As we all know from school biology, the formation of the embryo occurs after the sperm fertilizes the egg. If a woman has two eggs maturing at the same time and both are fertilized by two sperm, conception and subsequent development of twins occurs. Once again, we draw your attention to the fact that two different eggs are fertilized by two sperm. Both eggs and sperm have different genetic codes. This is why twins can be born completely different from each other - have different eye colors, different builds, different heights. Even the sex of the children can be different. They are no more similar to each other than ordinary brothers or sisters. Such a pregnancy is called dizygotic. In the same case, if only one egg cell matures and is fertilized by one sperm, it usually results in the birth of one child. However, sometimes a malfunction occurs in the body and the egg cell splits into two absolutely identical halves during division, which continue to develop in an absolutely normal way. However, due to the fact that the egg cell and the sperm were one, the genetic code of the children is also the same. Such children are called twins. Twins are always born only of the same sex, very similar in appearance, they have birthmarks in the same places, a tendency to the same diseases. Even the character of the children, as a rule, is very similar. Such a pregnancy is called monozygotic. As a rule, doctors easily determine di or monozygotic children.
Causes of multiple pregnancies
The second thing that needs to be talked about is thatwhat determines the birth of twins. Despite the fact that modern science and medicine are at a very high level of development, there is still no exact answer as to why multiple pregnancies occur. Below are the main reasons for the birth of twins known to date:
- The main reason doctors still believeheredity. The heredity on the maternal line is particularly affected by the possibility of multiple pregnancy. Although the heredity of the father can also cause a multiple pregnancy. Most often, this feature is transmitted through one generation, although exceptions to this rule are not so rare.
- Treatment of secondary infertility is also oftenleads to the onset of multiple pregnancies. For example, taking many hormonal drugs stimulates the maturation and release of several eggs at once. Under favorable circumstances, they are all fertilized, resulting in a multiple pregnancy.
- Pregnancy of twins after eco meetsapproximately 60% of all infertility treatment by artificial insemination. This phenomenon is explained very simply - a woman in the womb sits a few fertilized cells. Some of them die, and two or three embryos survive and continue to develop successfully. In some cases, doctors can remove one or two embryos. However, recently, to reduce the number of multiple pregnancies, doctors began to practice the transfer of just one - two embryos.
However, despite the knowledge that doctors have, they are not yet able to predict the likelihood of having twins.
Features of the course of multiple pregnancies
Twin pregnancy calendar is practicallycompletely coincides with the calendar of pregnancy with one child. The development of children occurs at almost the same time. However, unfortunately, with multiple pregnancies, complications occur much more often than with other pregnant women. The most common problems are:
- Iron deficiency anemia. As the kids develops two, the need for iron doubles. In the event that a woman does not take iron supplements in addition, there is a rather high risk of developing iron deficiency anemia.
- Preeclamps, also called the toxicosis of the secondhalf of pregnancy. When gestosis in the urine of a pregnant woman shows a large amount of protein, blood pressure rises to critical high marks.
- Placenta previa. With a complication such as placenta previa, the placenta is located in such a way that it overlaps the entrance to the uterus.
- Placental insufficiency. With this complication, doctors note insufficient blood circulation, as a result of which children do not receive enough nutrients.
- Various anomalies of fetal presentation - pelvic, transverse presentation.
- Retardation of intrauterine development of children.
- Dissociated development of the fetus. With this type of development, one fetus develops normally, and the second lags considerably behind. However, if you are faced with a similar problem, do not despair and be scared - with the timely begun adequate treatment of the life and health of the baby, nothing will be threatened.
- Twins are slightly higher than other children, the risk of developing intrauterine malformations.
- In addition, with multiple pregnancies, there is a much higher risk of premature birth.
In the first 12 weeks of pregnancy (firstтриместр) примерно в 20 % случаев у женщины наблюдается феномен, носящий название феномен отмирания плодного яйца. То плодное яйцо, которое отмирает, прекращает свое развитие и постепенно уменьшается в размерах. Полость матки плодное яйцо не покидает – остается там вплоть до самых родов. Это отмершее плодное яйцо не причиняет ребенку никакого вреда и не мешает нормально развиваться. Как уже говорилось выше, во втором и третьем триместре угроза прерывание беременности и преждевременных родов при многоплодной беременности наиболее высока. Она встречается примерно в 75 % всех случаев. Именно этим объясняется тот факт, что в случае, если женщина беременна двойней, практически на протяжении всей беременности врачи назначают женщине курсы препаратов, расслабляющих матку. Зачастую приема препаратов оказывается недостаточным. В таком случае женщину госпитализируют для лечения и сохранения беременности в родильные отделения, где она остается вплоть до родов, если срок уже большой, либо до улучшения состояния. Также очень часто женщины, вынашивающие двух и более детей, жалуются на различные нарушения работы сердечно – сосудистой системы. Во время беременности нагрузка на сердечно-сосудистую систему увеличивается вдвое. А если беременность многоплодная – то втрое, а то и вчетверо. Разумеется, что в таких экстремальных условиях работы сердечно – сосудистая система может давать сбои. Любые нарушения в нормальной работе сердца и сосудов могут повлечь за собой негативные последствия для здоровья, как будущей мамы, так и малыша. При появлении первых же симптомов недомогания беременная женщина обязательно должна своевременно обратиться за квалифицированной медицинской помощью. Малейшее промедление может стать непоправимой ошибкой и привести к непредсказуемым последствиям. Как уже говорилось выше, многоплодная беременность в разы повышает риск развития железодефицитной анемии. В случае многоплодной беременности плацентарная ткань значительно увеличивает свою массу, соответственно, увеличивается количество содержащихся плацентарных факторов, которые также провоцируют развитие анемии. Кроме того, во время многоплодной беременности значительно увеличивается внутрисосудистый объем крови. Соответственно, уровень гемоглобина снижается. У женщин, которые вынашивают двоих и более деток, очень часто роды начинаются преждевременно. Врачи называют главной причиной этого осложнения тот факт, что мышечные волокна матки при многоплодной беременности значительно перерастягиваются. Женщинам, которые собираются стать мамами двух малышей, необходимо с особым трепетом и вниманием относится к своему здоровью. При малейших признаках недомогания необходимо обратиться к врачу. Из-за того, что многоплодная беременность относится к категории беременности повышенного риска, врачи к таким женщинам относятся с особым, повышенным вниманием. Будущие мамы проходят гораздо больше количество всяческих обследований, они посещают женскую консультацию в два раза чаще остальных беременных. Ни в коем случае нельзя пытаться уклоняться от этого. Ведь здоровье ваших деток намного важнее, чем временные неудобства.
Diagnosis of multiple pregnancies
A question that interests almost all women,who learned that they will become mothers, this is - "pregnancy with twins, signs." This question is especially relevant in cases where a woman has already had cases of twins or triplets in her family. The possibility of giving birth to twins is much higher for them than for other women. However, there is no other way to determine a pregnancy with twins, except for visiting a doctor - a gynecologist. And for this you do not have to wait a lot of time - in our time, gynecologists can establish a pregnancy with twins already at the first visit of a woman to a antenatal clinic. Starting from the fourth obstetric week of pregnancy, the uterus in its size exceeds the size of the uterus at the same time, but with a singleton pregnancy. Some women try to find the symptoms of a twin pregnancy on their own. However, there are no reliable symptoms, and there cannot be. If until the end of the first trimester, the presence of multiple pregnancies can be assumed only by the size of the uterus, then already at the beginning of the second trimester, during the first ultrasound examination, the doctor can reliably talk about a multiple pregnancy, visualizing several fetal eggs. Sometimes there are cases when during the first ultrasound examination the doctor visualizes two fertilized eggs, and then one of them dies. And as a result, only one baby is born. And in some, much rarer cases, the doctor sees only one fertilized egg during the examination, while in fact there are two of them in the uterine cavity. Sometimes one fertilized egg simply covers the other, and it is not visible. But as soon as the babies grow a little, they will no longer be able to hide from the doctor. There is a misconception that the fact of multiple pregnancy can be established by doing a blood test for the value of the triple test for alpha-fetoprotein, estriol and chorionic gonadotropin. In a normal, singleton pregnancy, this test serves as an indicator of normal fetal development or, on the contrary, the presence of malformations and chromosomal abnormalities. However, this test does not always reveal the presence of multiple pregnancy.
Features of the course of multiple pregnancy and childbirth
As mentioned earlier, in case of multiple pregnancypregnancy, a woman is forced to visit a women's consultation more often than during a normal pregnancy. If the pregnancy is proceeding well, without any visible complications, the expectant mother, starting from the second trimester of pregnancy, should visit a women's consultation every ten days. And in the third trimester of pregnancy, visits to the gynecologist become more frequent, up to once a week. Doctors pay no less close attention to such an indicator as the weight of a woman pregnant with twins. If a woman is expecting the birth of one baby, her average weight gain will be approximately 10-12 kg. In the same case, if a woman is pregnant with twins, her weight gain will be about 15 kg. In no case should you allow yourself to gain excess weight. This can be a very heavy burden on the body of the expectant mother and lead to complications in the normal course of pregnancy. During a multiple pregnancy, a woman must be mentally prepared to go to hospital for treatment at any time. After all, in all cases of even the slightest deterioration in the condition of a woman pregnant with twins, doctors prefer not to risk the life of the mother and children, but to send her to the hospital. Before giving birth, the mother is also hospitalized two weeks before the expected date of birth. It would be reasonable to prepare all the things necessary for hospitalization, so that if such a need really arises, the expectant mother does not have to waste her time getting ready. The management of labor during multiple pregnancies still causes a lot of discussion among obstetricians and gynecologists. A unified tactic for managing such births has not yet been developed. In addition, in each specific case, doctors take into account a large number of individual factors, such as:
- The course of pregnancy.
- State of health of women.
- The state of health of children.
- Presentation of the fruits.
Doctors pay special attention toпредлежание и вес того малыша, который должен покинуть родовые пути первым. То есть очень рискованно вести роды естественным путем в том случае, если первый малыш находится в тазовом предлежании, а второй – в головном. В подобном случае малыши могут сцепиться головками, что значительно усложнит течение родового процесса, и даже может привести к гибели малышей. Конечно же, в подобном случае врачи предпочтут родоразрешение через кесарево сечение. Очень часто при многоплодной беременности возникает такое осложнение, как аномалии родовой деятельности. Она может быть слабой, либо же наоборот, слишком бурной. В таких случаях врачи, чтобы избежать развития всевозможных осложнений, прибегают к медикаментозной коррекции родовой деятельности. Существуют препараты, которые замедляют, или же напротив, усиливают родовую деятельность. Помимо лекарств используют также другие коррекционные методы. Например, если родовая деятельность довольно слабая, врачи после рождения первого малыша вскрывают второй плодный пузырь, что значительно сокращает интервал между рождением первого и второго плода. В том случае, если у детей наблюдаются признаки гипоксии, врачи могут принять меры об экстренном оперативном вмешательстве. Как уже неоднократно говорилось выше, при многоплодных беременностях роды начинаются на две – три недели раньше, чем при одноплодной. Однако природа позаботилась об этой особенности – созревание легких у таких малышей происходит раньше, чем у ребенка при одноплодной беременности. Таким образом, преждевременные роды для двойняшек и близняшек представляют гораздо меньшую опасность, чем для других недоношенных детей. Кроме того, ученые достоверно установили интересный факт. У однояйцовых близнецов адаптационный период после родов протекает не так, как у двуяйцовых. Однояйцовые близнецы гораздо хуже адаптируются к окружающей среде. У них гораздо чаще возникают хронические бронхиты, отечность и желтушный синдром. Начало родов при многоплодной беременности, так же как и при одноплодной, чаще всего происходит с излития околоплодных вод. Околоплодных вод при многоплодной беременности больше, ем при обычной. Поэтому мышечные волокна значительно растягиваются, в результате чего у женщины возникает слабость родовой деятельности. Именно поэтому врачи предпочитают производить вскрытие плодного пузыря уже при небольшом раскрытии шейки матки. Учитывая, что роды при многоплодной беременности чаще обыкновенных сопровождаются различными осложнениями, врачи предпочитают даже естественные роды вести на фоне эпидуральной анестезии. Эта мера позволит в случае необходимости немедленно провести кесарево сечение или иные оперативные вмешательства в естественное течение родового процесса. Также в большинстве случаев после того, как у женщины начались схватки, ей вводят внутривенный катетер. Это необходимо для того, чтобы у врачей в любой момент была возможность быстро ввести необходимые фармакологические препараты. Если женщина чувствует себя неважно, ослаблена, ей могут поставить капельницу с раствором глюкозы, для поддержания сил. Период схваток аналогичен при любой беременности – как одноплодной, так и многоплодной. А во время потуг, сразу же, после рождения первого малыша, врачи вскрывают второй плодный пузырь, после чего вводят лекарственные средства, которые стимулируют сокращение матки. Беременные женщины часто задают вопрос о том, сколько времени проходит между рождением первого и второго малыша. На самом деле, однозначно ответить на этот вопрос нельзя. То, сколько времени пройдет между рождением деток, зависит от того, насколько эффективны потуги. Как правило, старший малыш рождается на 20 – 30 минут раньше младшего, в том случае, если детки дизиготные. Если же речь идет о монозиготных малышах, разница составляет не более 10 минут. Послеродовая реабилитация новоиспеченной мамочки двух и более малышей совершенно ничем не отличается от таковой же при обычной, одноплодной. И даже кормление грудью близнецов – не такое уж трудное дело. Пройдет совсем немного времени, и вы с легкостью будете справляться с этой задачей. Очень многие родители, наслушавшиеся страшных рассказов о рождении близнецов, беспокоятся о том, что их малыши родятся с экстремально низким весом. Однако все эти рассказы – не более чем обычные байки. В том случае, если беременность протека нормально, а дети рождены не намного раньше срока, их масса тела не будет критически низкой. Вес близнецов при рождении меньше обычного в среднем на 300 – 400 грамм. Развитие малышей также соответствует средневозрастным нормам. Никаких отклонений от нормы у здоровых малышей не наблюдается.
Payments and benefits
As is known, our state providesfinancial support at the birth of a child. And if in the case of the birth of one child no questions arise, then in the case of twins, various misunderstandings and misunderstandings often occur. Often, parents do not know all their rights, and even accounting workers are often confused about what payments are due to an employee who has twins. So, what does the law say about this? In the event that two or more children are born in a family at the same time, a one-time benefit at the birth of a child is paid for each of them, regardless of their number. To receive the benefit, parents must submit the relevant documents to the local social security authorities, if the parents are not officially employed at the time of birth and can document their unemployed status. If the parents work, the payment of a one-time benefit for the birth of twins is made in the accounting department of the enterprise where the mother or father of the children works. What documents are needed for this, you need to clarify at the place of receipt of the benefit. A one-time benefit for the birth of twins is paid only at the place of work of one of the parents. If the parents are students, payments are made at the place of study. Also, very often new mothers ask the question about how the child care allowance is paid up to one and a half years in the case of the birth of twins. The law states the following about this: if a woman cares for two or more children at the same time, the amount of the benefit paid increases proportionally to the number of children. However, the total amount of the child care allowance up to one and a half years cannot exceed 100% of the mother's salary. It is also necessary to remind that in addition to state payments, there are also regional one-time payments at the birth of a child. The funds for these payments are taken from regional budgets. The amount of these payments may vary depending on the region. To receive them, you must also contact your place of work or the social security authorities. The allowance must be accrued no more than ten days after the application and all necessary documents are submitted. An approximate list of documents is given below:
- Application for the assignment of the necessary benefits, written in accordance with the established pattern.
- Information about the birth of children, which you will be given in the registration office along with the certificate of the birth of your baby.
- A certificate stating that the second parent did not receive a birth allowance at work.
If the parents do not work, as already mentionedabove, you need to contact the social security authorities at your place of registration, where payments will be made upon the birth of twins. To do this, you need to prepare the following documents:
- The application for a lump-sum benefit, it is necessary to indicate the account number in the bank to which the allowance will be transferred.
- References from the registry office about the birth of children.
- It is mandatory to provide a copy of the work record card or military ticket.
- A photocopy of the passport or other identification document.
- A photocopy of a personal savings book.
- If a woman has the status of a single mother, sheit is necessary to submit a document confirming this fact. Such a certificate a woman can always get in that registry office, in which she registered the birth of her toddlers.
As everyone knows, families in which a child was bornthe second and third child, have the right to receive maternity capital. Maternity capital for the birth of twins is paid for the second child. In order to receive it, the family must contact the Pension Fund at the place of their registration. You must submit the following documents:
- Filled in accordance with the established pattern of applicationto receive maternity capital. This application can be taken in the pension fund or downloaded from the official website of the Pension Fund of the Russian Federation.
- A photocopy and original of the applicant's passport.
- A copy and original of the certificate of compulsory pension insurance.
- Copy and original of the birth certificate of children.
- A certificate that the child has Russian citizenship.
No additional benefits at birthTwins are not provided for by Russian legislation. However, if there are other children in the family, upon the birth of twins it automatically becomes a large family and acquires all the benefits that are due in such cases. To receive the benefits due to large families, you must also contact your local social security authorities. Very soon all the worries and anxiety will subside, all bureaucratic procedures will be completed. The life of your family will return to normal, your children will grow up and delight you with more and more new successes. In the meantime, all this is only ahead, enjoy your new position and let the days of waiting for the birth of your babies not be overshadowed by any troubles. We advise you to read:
