The Guinness World Records’ Instagram page has left people more curious than ever about multiple births! Halima Cisse, an African lady, gave birth to nine children last year in Casablanca, the port city of Morocco, with five girls and four boys. The children have now been given a certificate of the ‘Most children delivered at a single birth to survive’! With the world-famous Malina nonuplets back in news, it seems worth exploring how with the rising pregnancy complications rate, cases of multiple births are on an upward trend too. Of course, nine kids is a rare case. But let’s understand the causes behind twins, triplets, and multiple pregnancies as well as their risk factors.

Multiple pregnancies

According to Dr Aarthi Bharat, Consultant – Obstetrician and Gynaecologist, Motherhood Hospitals, Banashankari, Bengaluru, there are two sides to being a mother to multiple babies. At times, it can be both overwhelming and exciting and can be a happy event for many couples. You would want to do everything possible to ensure the health of you and your babies.

Multiple pregnancies (twins, triplets, or higher-order multiples) carry specific risks and complications for both the babies and the mother. One of the most common complications for multiple pregnancies is preterm delivery, a delivery that occurs before 37 weeks, which can lead to an infant with low birth weight along with feeding and breathing difficulties. However, multiple pregnancies have increased risks for complications.

Check out a video posted by Guinness World Records of the surviving nonuplets right here!

Here are 8 significant complications and symptoms of multiple pregnancies:

Dr Bharat outlined the following risks of multiple births that every couple should be aware.

1. Gestational hypertension

Mothers with multiple fetuses are two to five times more likely to develop high blood pressure during pregnancy. The condition often develops early and is more severe than in pregnancy with just one baby. The increased blood pressure in women results in high chances of placental abruption (early detachment of the placenta).

2. Intrauterine growth restriction

Intrauterine growth restriction (IUGR) is also a type of condition in which an unborn baby tends to weigh less than expected for a particular gestational age (according to singleton babies). This condition is detected with a growth ultrasound, and the estimated weight falls below 10 percent. As a result, your pregnancy is complicated by the growth restriction of one of your babies, you will need to increase the frequency of daily visits to your doctor and monitor the pregnancy with antenatal testing.

Antenatal testing refers to testing, which occurs before birth to evaluate and analyze the well-being of the babies in the late third trimester of pregnancy. It includes ultrasound and external electronic fetal heart rate monitoring.

3. Anemia

Anemia is more common in multiple pregnancies than in a single pregnancy. It is a medical condition for which the count of healthy red blood cells is low, it carries oxygen to organs and tissues. Due to greater nutritional demands, there is a higher risk for women who are carrying multiple babies, resulting in developing the need for anemia. After anemia, you will probably feel tired and weak.

4. Twin-to-twin transfusion syndrome

Twin-to-twin transfusion syndrome (TTTS) is a condition of the placenta which develops in identical twins who share the same placenta. The blood vessels in the mother’s body connect within the placenta and divert blood from one fetus to the other.

It occurs in up to 10-20 percent of twins who share the same placenta. In a shared placenta, the blood is shunted from one fetus to the other through blood vessel connections. Over time, the recipient fetus receives too much blood, which can overload the cardiovascular system, which develops too much amniotic fluid to develop. As a result, a smaller donor fetus does not get enough blood and has low amounts of amniotic fluid, which can also cause severe problems.

5. Abnormal amounts of amniotic fluid

Polyhydramnios which means too much fluid, and oligohydramnios which means too little fluid, it is more common in multiple pregnancies, especially in twins who share the same placenta.

Also read: Expecting twins? Learn how twin pregnancy is different from a singleton pregnancy

6. Miscarriage

Vanishing twin syndrome, in which more than one fetus is found through testing, but the other one vanishes or is miscarried. It might occur in multiple pregnancies, this usually happens during the first trimester, and it is not necessary to be accompanied by bleeding. Although, the risk of miscarriage is increased in the later trimesters as well.

7. Sciatica and low-back pain

Sciatica (pain or tingling in the leg) and low-back pain are more common during multiple pregnancies but are not considered dangerous. To prevent these consequences mothers are advised on opting for healthy lifestyles.

8. Birth defects

Mothers can be prone to congenital abnormalities due to multiple birth babies resulting in higher chances of risk, including neural tube defects like spina bifida and gastrointestinal and heart abnormalities. Mothers are highly advised to go for regular counselling sessions during this time.