Signs and Symptoms of Having Twins

Pregnancy starts a new journey and loads of responsibilities, which heightens further the moment you discover that instead of one, you are carrying two little munchkins. Though you have to play the guessing game to know whether you are carrying twins or not before your ultrasound, certain common signs of twin pregnancy that are visible quite early, like acute morning sickness or excessive breast tenderness, may give you a hint, while other symptoms eventually show up.

How early can you detect a twin pregnancy?

Many mothers with twins have encountered symptoms earlier than those with a singleton pregnancy. However, you cannot know for sure until your ultrasound, often done between the 10th and 13th (plus 6 days) weeks. If your pregnancy results from fertility treatment, the scan may be done as soon as the 6^th week.

Are pregnancy symptoms worse with twins?

Pregnancy symptoms with twins are no different, but their intensity may be more exaggerated, varying from one mother to another.

Twin pregnancy symptoms: Week by week

Early signs and symptoms of being pregnant with twins

Intense morning sickness: The high HCG(human chorionic gonadotropin) hormone levels are the main cause of morning sickness, occurring between the 6th and 8th week of pregnancy. If pregnant with twins, you may experience nausea and vomiting as early as the 4th or 5th week, even before you have missed your periods, the babies being as tiny as a poppy seed. Hyperemesis gravid arum or severe morning sickness is also likely to occur, requiring intravenous fluids in extreme cases.
A bigger bump: Your bump might look larger than your expected delivery date with two babies sitting there. However, other reasons for an oversized bump may be discrepancies in due dates and changing posture of the baby. Women in their second pregnancy also have a big belly as their stomach muscles stretch after the first one.
High fatigue level: Being one of the first signs of twin pregnancy, you would go through extreme exhaustion and tiredness as early as the 7th or 8th week from conception and in the last trimester.
Sore breasts: Because of the hormonal changes that increase the blood flow, resulting in changes in breast tissues, they get soft and sore in the first trimester, starting from the 4^th or 6^th week. Women with twins would have more delicate breasts due to greater hormonal change.
High food cravings: Researchers often speculate that food cravings happen either because of hormonal changes or to make up for a nutrient deficiency. Common signs like increased or frequently changing appetites are seen from the beginning.
Shortness of breath: Because of the high levels of progesterone released during pregnancy, shortness of breath is a common phenomenon that intensifies if you are carrying twins as the hormone levels are even higher. Moreover, as you step into the last trimester ( between the 28th and 40th week), breathing problems may worsen since two babies push against the diaphragm.
Heartburn: You may have heartburn from the beginning, first due to the higher hormone levels, and later with two babies exerting pressure on your tummy.
Spotting: It is more likely to occur in twin or multiple pregnancies, which is nothing to worry about as long as there is only a little bleeding without any cramps or blood clots. However, it is also common in those who have conceived through IVF, even when carrying a single baby.
Early pregnancy hCG test: An hCG (Human Chorionic Gonadotrophin Hormone) test done early in pregnancy is another way to determine twins, even before an ultrasound. High hCG levels may hint toward a twin pregnancy as the hormone levels usually rise 30 to 50% higher for twins and multiple babies. However, this may not always be genuine since the hCG levels are also high if you undergo fertility treatment to get pregnant.

Late symptoms to know if you are pregnant with twins

Fast weight gain: 10 to 12 pounds of fetal weight, coupled with the volume of blood, water weight, and amniotic fluid, accounts for an increased weight gain when pregnant. You will put on a little more if there are two babies in your womb, with the weight rising by 4 to 6 pounds in the first trimester, increasing by one and a half pounds each trimester.
Increased swelling: Swelling is common during pregnancy as the body needs to produce more blood and fluids to cater to the baby’s needs. You would experience more of it when carrying twins since your body must meet double the requirements.
Early fetal movement: When expecting twins, it is common to feel the flutters before the 15th or 16th week. However, sensing early fetal movement also depends on factors like your height and weight and the number of pregnancies you previously had.
Back pain: Back pain increases as you move into the latter stages since more stress is on the muscles carrying additional weight.

Warning signs when you are pregnant with twins

1. Preeclampsia

Its risk is three times more than in a single pregnancy, which can even proceed to eclampsia in some cases.

Symptoms:

Nausea
Vomiting
Headache
Excessive swelling in face and hands
Trouble in urinating

2. Miscarriage

Miscarriage is more common in twin pregnancies, where one may lose both babies, or just one of the twins may disappear in the middle of the pregnancy (vanishing twin syndrome).

Symptoms:

Heavy vaginal bleeding
Cramps
Clotting
Pelvic pain

3. Preterm Labor

It is a common occurrence where babies are born before the 36th week.

Symptoms:

Frequent uterine contractions occurring every ten minutes or less
Dull back pain that comes and goes
Vaginal fluid leakage
An increased amount of vaginal discharge
Reduced fetal movement
Abdominal cramping
Increased vaginal pressure
Nausea, vomiting, or diarrhea

References:

Roy Mashiach

Dr. Mashiach has completed his MD at the Sackler School of Medicine, TAU; specialization in gynecology at the Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center; fellowship in Endoscopy at the Polyclinique de I’Hotel-Dieu, Universite d’Auvergne, Clermont, France.

He is a Senior Physician, Director of the Department of Gynecology, which provides routine and preventative care services to its patients and a full range of gynecological surgical procedures for adequately managing its patients with benign gynecologic disorders.

He offers advanced care in all gynecological subspecialties such as Urogynecology, Colposcopy, Fetal Loss Clinic, and Post Menopausal Clinic.

Signs and Symptoms to Tell if You are Having Twins

How early can you detect a twin pregnancy?

Are pregnancy symptoms worse with twins?

Twin pregnancy symptoms: Week by week

Early signs and symptoms of being pregnant with twins

Late symptoms to know if you are pregnant with twins