Tuesday, June 24, 2014

When the doctor wonders if there may be twins........

When a mother is larger than normal in early pregnancy, that can be a sign that there are twins. If only one baby is born, that baby will probably be a womb twin survivor. In the days before the routine use of  ultrasound,  all we could know is that the womb is bigger than  it should be.

Another sign is that yea Mum has a very large bulge at an early stage, but after a few weeks things suddenly change and the pregnancy seems normal from then onand the womb no bigger then expected. This change may also involve a sudden relief of morning sickness or an end to crippling fatigue.  All signs that a major change has taken place - ie where there were two babies, there is now only one.

In a twin pregnancy the uterus grows much faster and will be much bigger than in a singleton pregnancy. At 13 weeks, the fundal height may be around 20cm or so which  can make the pregnant woman seem fulrther along in the pregnancy that would be .

For example in 1975 Margaret  was only 12 weeks pregnant but had to move into maternity wear because her waist had expanded so much.   There were  no ultrasound scans then so the doctor had to carry out an internal examination if her uterus. " there is something there...."  the doctor said. Only one baby was born in the end, very large and difficult to deliver.  Many years later that baby was showing clear signs of being a monozygotic (MZ) womb twin survivor.  What proof was there that this may be the case? Only the size of her uterus in the first trimester, but perhaps that is proof enough.

In another case, Susan was at work when she became pregnant for the first time.  Being of an athletic build she did not show at first, but her pregnancy did become obvious to her workmates by 14 weeks or so.  She was off work with mastitis for a week and when she returned people asked: have you lost your baby?  This was not because she had been off work, but because she suddenly looked much smaller. The sole survivor of this pregnancy began to show signs of being a DZ womb twin survivor  (fear of abandonment, hypersensitivity) by the time he was two years old. What proof was there in this case? Only the sudden change on the size of her uterus, but perhaps that also is proof enough.

A very slim mother may show her pregnancy earlier than most and if she does have twins for the first trimester, various people, including doctors and nurses may suspect twins, but by the time of the first scan at 16 weeks, the twin conception has reduced to one baby - a womb twin survivor.

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