Dr. Cook explains why women carrying multiple babies are likely to have a premature delivery and shares the risks commonly associated with multiple births.
Certainly curing multiple gestations is an increased risk factor for preterm delivery. We usually say that you lose about three weeks of gestation for each additional fetus or each additional passenger. So with twins, the average gestational age may be 36-37 weeks, for triplets it may be 33-34 weeks and you can keep going backward as you get more and more fetuses present.
It’s a question we get a lot, I mean obviously earlier on the focus is on preterm labor and growth of the babies, but the moms frequently ask, “What is this going to do to me?”
Well generally speaking, the over distention of the abdominal wall in the uterus will go back to a more normal kind of appearance after delivery, but the delivery process is more complicated in a multiple gestation, the biggest risk being the risk for increased bleeding because the uterus is so distended and it has to shrink down to a normal size to control the bleeding. So that’s the biggest issue we watch for at time of delivery.
In the latter part of the pregnancy we watch for maternal complications like diabetes or hypertension, by hypertension we mean elevated blood pressures; blood pressure elevation specific to pregnancy, we talk about preeclampsia. So that’s frequently a reason we need to deliver prematurely in multiple gestations, not just because pre-term labor, but because a developed preeclampsia or blood pressure problems and that can pose significant risk to mothers if left undelivered in that situation.
About Dr. Curtis Cook, M.D.:
Dr. Curtis R. Cook, M.D., is a maternal-fatal medicine specialist and the Associate Director for Phoenix Perinatal Associates providing care for women with complicated, high-risk pregnancies. Dr. Cook received his medical degree from Indiana University School of Medicine and completed his residency at Butterworth Hospital in Michigan.