MULTIPLE

PREGNANCY;PREDISPOSI
NG FACTORS AND
COMPLICATIONS
Regular/2018/116633

BY NWALA CHIAMAKA RUTH

DEFINITION

 Multiple pregnancy is a pregnancy with

two or more fetuses. This occurs when
the ovary releases more than one egg
during ovulation and one or more eggs
are being fertilized by sperm.
 According to their number, they
could be categorized into:
Twins (most common)
 Triplets
Quadruplets
Quintuplets
Sextuplets
 Types
 FRATERNAL TWINS
IDENTICAL TWINS
 Two separate eggs are fertilised Identical twins are formed
and implanted in the uterus. A when a single fertilised egg is
split in half. Each half embryo is
pregnancy with fraternal twins is
genetically identical,so the
statically the lowest risk of all babies share the same DNA
pregnancies since each baby has it and also the babies will share
own planceta and amniotic sac. many characteristics. The are
referred to as monozygotic
fraternal twins are referred to as
twins
dizygotic twins referring to 2
zygotes ( fertilised eggs)
CAUSES

• Heredity: A family history of multiple pregnancy raises the chance of having

twins .
• High parity: having 1 or more previous pregnancies, especially multiple
pregnancy.
• Race:African American women are more likely to have twins. Asians and
native Americans have lower rates
• Ovulation stimulating medicines such as clomiphene citrate and follicle
stimulating hormone,can help produce many eggs
• Assisted reproduction technologies : in vitro fertilization (IVF) and other
methods may help couples pregnant.
CLINICAL MANIFESTATIONS

 Uterus is larger than expected for the dates of the

pregnancy
 Too much weight gain,especially in early pregnancy
 Fetal movements felt in different parts of the
stomach at the same time
 Greater appetite
COMPLICATIONS

 Preterm labour/delivery
 Low birth weight
 Intrauterine growth restrictions
 Gestational diabetes
 Preeclampsia
 Cesarean sections
DIAGNOSTIC TESTS

 Pregnancy blood testing : level of human chronic gonadotropin (HCG)

may be quite high with multiple pregnancy
 Alpha fetoprotein. Levels of a protein release by the fetal liver and found
in the mother's blood may be high when 1 fetus is making the protein
 ultrasound : this is an imaging test that uses high sound waves to create
images of blood vessels, tissues, and organs. Ultrasound can be done this
a vaginal tranceducer, especially in early pregnancy or they can be done
with an abdominal transducer later pregnancy
RECOMMENDATIONS

The following are recommended in the management of multiple pregnancy.

 The midwife should understand that multiple pregis a high risk pregnancy
and thus it requires the mothers are monitored more often
 The midwife should encourage mothers with multiple pregnancy to go for
routine antenatal care to enhance early detection of complications for
prompt management and they should be ready to make referrals when
necessary.
CONCLUSION
 It has been understood that multiple pregnancy is a pregnancy
with two or more fetuses and the causes are mostly attributed
to hereditary,Race,high parity,and it's incidence has further
increased with the use of assisted reproductive technology e.g.
Ivf and ovulation stimulating drugs e.g. clomiphen citrate.
Multiple pregnancy is a high risk pregnancy association with
complications such as preeclampsia,preterm labour,placenta
abruption,gestational diabetes .
THANK YOU
FOR
LISTENING