Twin-births

Definition and frequency

A simultaneous development of two children takes place at twins in a pregnancy. Multiple birth is speaking if two or more children ripen

Die Häufigkeit des Auftretensz. B. of twins calculates itself after the Hellin rule:
  • a twin-birth (1.18%) comes onto every 85th birth,
  • on births which are 852 (= 7.225.) a triplet birth (0.013%),
  • on births which are 853 = (614,125) a quadruplet birth (1:614125).
An increased probability that this happens again consists in families in which twin or multiple births have already appeared. A rising of multiple births the last decade has to be watched. The reason for it lies in it that after sterility medical treatments multiple births appear with hormones and/or an artificial insemination piled up.

Emergence

After its emergence one distinguishes monovular and dizygotic twins. Dizygotic twins are more frequent three times. Monozygotic twins arise from a stimulated ovum which divides itself into two separate germ layers in a very early stage of development. This happens within the first three days of the development, a walk independent of each other is carried out in the oviduct and a separate one settle in the womb. Both children have an independent fetus cavity and placenta. If it comes only to the division in the womb after a differentiation of the embryonic envelopes has already taken place, then the twins have a common placenta and they possibly lie in an amniotic sac. Monozygotic twins have identical genetic traitses and always the same sex. Dizygotic twins arise from the fertilization of two ovums. It can be from either one or the two ovaries. You always have a placenta of your own and fetus cavity. You can be the same or different sexual and are related to each other genetically like other brothers and sisters also.

Diagnosis

Already at the first ultrasound scan a twin pregnancy is recognized. However, there are also other indications. The womb is more greatly than it correspond to the pregnancy age, the weight and the abdomen size of the nascent mother increase more strongly. It feels strikingly many fetal movements. The twin pregnancy is safeguarded by the derivation fetal heart sounds in two different places and the detection of different heart rate specimens.

Pregnancy

A twin pregnancy is always classified as high-risk pregnancy. It represents a considerable additional load for the maternal organism. The supervision of the pregnancy is more closely carried out to recognize for example a deficiency care of the children. More frequently complications and pregnancy specific diseases appear, the pregnancy troubles can be amplified. Bleedings, premature labors, a being missing or premature delivery and increased fetus water quantity as well as one gestosis must be expected.

Birth

The birth is also classified as high-risk delivery. The children come for the most part onto the world three to four weeks too early since the womb has usually at this time reached their maximal size. It is therefore advisable to look at full term for a clinic which has experience with twin and multiple births. If the children weren't born until the 38th week yet, the obstetricians advise to end the pregnancy because of a possible overload of the placenta. Twins can be released vaginally. However, are prerequisites for it that the children weigh gram at least 2000 and the first twin lies with the head after below. Because of the over-stretching of the womb labor anomalies, such as a bradytocia, can appear. With an oxytocin drip this is counteracted. The birth of the first twin is normally carried out. The birth of the second child should be carried out within 15 -20 minutes. It is endangered due to the womb reduction and the danger of a premature placenta detachment. The birth is then often ended by vaginal delivery operations, con-way of playing with a suction cup. An end of the birth of the second child by a cesarean section is rather rare. From the start, a cesarean section is recommended at twins, if the children or a twin is very small or tall/is, they unite weight difference have gram of more than 500 and at abnormal lies.

Risks

The risk of dying at the birth is with women, the one have increased multiple birth by the triple opposite mothers which deliver only a child. The infant mortality rate is even increased by 10 to 20 per cent. This is mainly due to the considerable share in premature deliveries.


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