5. You measure large for gestational age. At your first exam you may be told that your uterus is "large for dates." If your last menstrual period indicates an eight-week gestation, your uterus may feel more like 10 to 12 weeks. This may prompt your care provider to request an ultrasound. As your pregnancy progresses, if you are carrying more than one baby, your fundal height (uterine measurement) will consistently measure large for gestational age. A term uterus, with one baby, may reach 38 to 40 centimeters in height, measured from the pubic bone, while a term twin pregnancy may exceed 48 centimeters.
6. You are told that you have elevated levels of AFP. Levels of alpha fetoprotein (AFP), a protein released by the baby as it grows and found in the mother's blood, can be elevated when there is more than one baby. (It can also be elevated for other reasons, such as neural tube defects.) Normally this simple blood test is given 16 to 18 weeks after your last menstrual period. Alpha fetoprotein testing detects over half of all twin pregnancies.
7. You are told you have rapidly rising hCG levels. Human Chorionic Gonadotrophin (hCG) is a hormone produced by the fertilized egg and by the chorionic villi. It is needed to maintain the pregnancy until the placenta develops. It can be detected in your blood or urine even before you miss a period. Normally in a singleton pregnancy, blood (serum) concentrations of hCG rise rapidly during the first weeks, doubling every two to three days. Levels of hCG can be even higher with twin or multiple pregnancies.
8. Your provider hears two fetal heartbeats. Two separate heartbeats can be distinguishable with a Doppler in your care provider's office by around 12 weeks. At around 28 weeks, it may be possible to differentiate two fetal heads and multiple small parts when doing an abdominal exam.
9. You have a positive ultrasound. If you believe you are indeed pregnant with twins, an ultrasound can be performed quite early in pregnancy. With a skilled ultrasonographer, two gestational sacs, two embryos and two distinct fetal heartbeats can be seen six weeks after the first day of the last menstrual period. Many twins have been diagnosed as early as five weeks -- when you're just one week late for your menstrual period.
6. You are told that you have elevated levels of AFP. Levels of alpha fetoprotein (AFP), a protein released by the baby as it grows and found in the mother's blood, can be elevated when there is more than one baby. (It can also be elevated for other reasons, such as neural tube defects.) Normally this simple blood test is given 16 to 18 weeks after your last menstrual period. Alpha fetoprotein testing detects over half of all twin pregnancies.
7. You are told you have rapidly rising hCG levels. Human Chorionic Gonadotrophin (hCG) is a hormone produced by the fertilized egg and by the chorionic villi. It is needed to maintain the pregnancy until the placenta develops. It can be detected in your blood or urine even before you miss a period. Normally in a singleton pregnancy, blood (serum) concentrations of hCG rise rapidly during the first weeks, doubling every two to three days. Levels of hCG can be even higher with twin or multiple pregnancies.
8. Your provider hears two fetal heartbeats. Two separate heartbeats can be distinguishable with a Doppler in your care provider's office by around 12 weeks. At around 28 weeks, it may be possible to differentiate two fetal heads and multiple small parts when doing an abdominal exam.
9. You have a positive ultrasound. If you believe you are indeed pregnant with twins, an ultrasound can be performed quite early in pregnancy. With a skilled ultrasonographer, two gestational sacs, two embryos and two distinct fetal heartbeats can be seen six weeks after the first day of the last menstrual period. Many twins have been diagnosed as early as five weeks -- when you're just one week late for your menstrual period.
Pregnant with Multiples board |
