The size of the belly of a woman pregnant with triplets breaks all records. How does a multiple pregnancy proceed?

05.07.202327.05.2017

Video film about multiple pregnancy, everything starts small and becomes what nature intended. Pregnancy and birth of twins, as well as triplets and quadruplets, occurs differently than during a singleton pregnancy. For the mother of future twins, this pregnancy will be the most turbulent and somewhat difficult, so it is impossible to do without the help of doctors and relatives to observe and help along the way.

The sperm meets the egg and the wonderful journey to human life begins. But in this case, something even more surprising happens. The fertilized egg splits into two parts, creating identical twins. Each egg is then split once more into 4 identical twins. The probability of such an event is 1 in sixty-four million. For the first time, we will follow 3 pregnancies in detail using revolutionary new imaging tools. We're talking about this, 1 egg twin, these triplets conceived on different days, and these wonderful 4 identical twins. We will find out how this happens and how science explains the amazing miracle of human reproduction.

The miracle of the birth of twins.

Life before birth, twins and triplets and quadruplets! This baby will be born soon. But for her, being in her mother's womb was not a relaxing pastime. Being born was not the first time she met other people. She shared this space with not one but three sisters. Each grew from an egg, smaller than a grain of sand, each exists separately, and does not realize that one of the four sisters is nearby, who touches them, reacts and seems to kiss them. They fought for food and space, and laid the foundation for warmth, comfort and good relationships for life. They helped each other develop and created patterns of connection and behavior that would define their lives.

Their path, like the path of each of us, begins with the act of conception. During this act, an average healthy man injects approximately 300 million sperm into a woman's vagina. Sperm swim through the genital tract to the fallopian tubes, their destination is not a fertilized egg. During the reproductive cycle, a woman usually releases one egg. The winner will be the sperm that is the first to approach it and penetrate its outer shell. Inside the egg, the head of the sperm with the father's DNA and the nucleus of the egg with the mother's DNA are connected by microscopic fibers called centrosomes.

This is the first cell that will give rise to a new human life. During the first few hours, the fertilized egg travels down the fallopian tube to the uterus. A day later, it separates for the first time. On the second day the number of cells is 4, on the third 8, by the fifth day a blastocyst is formed. It has from 70 to 120 cells and consists of two parts, the inner cell mass will develop into the fetus, the outer spherical mass, the so-called trophoblast, forms the extremely important placenta. Approximately on the sixth day, the blastocyst breaks through the membrane of the egg and attaches to the wall of the uterus, and then begins to penetrate into it, where it will remain for 39 weeks. The blastocyst will develop into an embryo, the embryo will develop into a raft, and the fetus will develop into a child.

But in a small number of cases, one in 250, something unusual happens to the egg. It splits into two parts and two separate fertilized eggs appear. Separate but identical. No one fully understands why this happens, but one clue may lie in the very nature of the egg. The largest number of cases of conceiving identical twins occurs in women at the beginning of late reproductive age. Some scientists believe that mature women have weaker eggs and are more susceptible to splitting. What we know for sure is that if this did not happen in the first 14 days after conception, then it will never happen.

Identical twins are the biological consequence of the closest human relationships. They will grow up strikingly similar to each other in every way, but they are not 100% similar. A small number of genes in the mother's egg are located outside the nucleus. Known as mitochondrial DNA, these genes can mutate after the nucleus splits, subtly altering the course of each embryo's development. As twins grow older, subtle changes in height, physique, and even personality traits will become increasingly apparent. This is why some scientists today use the word identical with caution and prefer the terms monozygotic or identical twins.

Identical twins are almost always the same sex, but surprisingly there is a very small percentage of opposite-sex monozygotic twins being born. They develop from an egg containing a rare combination of sex chromosomes; they usually have two (x) chromosomes for a girl and (xy) chromosomes for a boy. Sometimes an egg contains three sex chromosomes 2 (x) and 1 (y). But during the process of egg separation, which involves the development of monozygotic twins, one chromosome may disappear.

Our two identical identical twins have been in the womb for 6 days. As is the case with one fruit, each of them will develop in two shells. The outer chorion is attached to the placenta and the inner amnion or amniotic sac which eventually joins together. Some twins share a common chorion. Very few have a common amnion. As they develop, they will compete for space and food that their mother will give them. In addition, they may have one common deepest strong connection. Julie is a very unusual woman, she does not know that one and the egg was divided not into 2, but into four parts. She may be one of the few women in the world currently pregnant with four identical twins. The chance of this happening is one in 64 million. Each of these tiny embryos has its own amnion, but they all have a common chorion, and with it the placenta. As a result, they will share the same source of nutrition and oxygen for thirty long weeks, biologically speaking they will be the closest twins conceived in the human body.

The case of this woman, Rachel, is completely different; she developed two eggs in different ovaries. And they were fertilized by different sperm. She is pregnant with fraternal twins, also called fraternal or dizygotic. It's like two separate pregnancies that started on the same day. Unlike identical twins, genetically fraternal twins are no different from ordinary siblings who share only half of their genes.

Unlike identical twin pregnancies, fraternal twin pregnancies are not uncommon. Statistics suggest that race may play a role here. Among Eastern women, 1 pregnancy with fraternal twins occurs in 400 pregnancies, among white American women 1 in 88, among Nigerian women, twins are born in one case out of 25. Other factors include periods when spouses have sex more often, for example, the first months after marriage or certain times of the year . Women in adulthood are also more likely to have twins. Belinda, 34, from an Afro-Caribbean family, is the most likely candidate. Her two fertilized eggs are implanted in different parts of the uterus, each will develop separately with its own chorion, placenta and amnion. The impressive 4D scan reveals the dividing wall of the outer layer of each membrane.

Day 7, all eggs implanted in the uterus of the expectant mothers. In the coming days, the blastocyst will begin to penetrate the uterine mucosa, which has swollen under the influence of hormones. A small army of cells invades the uterus and gradually splits into two, forming the primary connections between the placenta and the mother's bloodstream. The first change occurs in the cluster of cells inside the blastocyst. First, two layers are formed. By the ninth day, the two layers become a disk with an indentation above it, the future amniotic sac, and an indentation below it, the future yolk sac. A depression appears in the middle of the disk, which is called the primitive streak. Cells move towards the primitive streak and merge into it. By the fourteenth day, another formation appears at one edge of the primary stripe. The so-called embryonic organizer. Up to this point, all developing cells in the body were the same, these are the so-called stem cells. Then each cell floats over the organizer, after which each of them finds its destiny, some will become part of the leg, others will become part of the arm, 3 cells of the lens of the eye.

The protrusion of the tiny embryo does not yet look like a head, but by the fifteenth day, in the area where the brain and spine will be, nerve cells begin to form, completely open, unprotected by skin or bones. At this time, the formation of the embryo occurs in the form of a three-layer formation. The first layer is the ectoderm of the skin and nervous system, the 2nd mesoderm is the muscles of the bones, the heart, and finally the endoderm from which the lining of the stomach, lungs, liver and pancreas will develop. At this stage, there will be enough space in the uterus for these primordial embryos to develop together.

One of the first organs to form is the heart. Until now it was a motionless collection of muscle cells. Then, on approximately the twenty-second day, one cell begins to spontaneously contract; it awakens neighboring cells and begins a chain reaction that ends with the pulsation of the entire mass. Primary blood cells begin to pump through blood vessels no thicker than a hair, providing the rapidly growing embryo with the necessary nutrition and oxygen. Later, when the brain develops more, it will begin to regulate the frequency of contractions, increasing it when more nutrition is required and decreasing it when the body of the embryo is at rest. On average, a person's heart beats 3 billion times during their lifetime.

After a month, the developing embryos are still small, a little more than 6 millimeters in size, about the size of a small bean. There is still enough space for their growth; the volume of the uterus is 6 liters, which is comparable to the volume of a large watermelon. The embryos have gills and a tail, a remnant of our evolutionary past. They develop in about 4 weeks and disappear by 6 weeks. The limb buds extend from the central part of the body outward. The eyes are just beginning to form; an optic cup is formed, which will become the eyeball, as well as a pigment layer that looks like a dot in the center. The oral cavity and passages appear that form the inner ear. The outer ear has yet to develop. At this stage of development, their heart beats as if from the outside of the body.

Fifth week

Five weeks into fetal development, our two twins are growing quickly. But according to scientific data, although identical and fraternal pregnancies are the most common types of multiple pregnancies, there is another type. A combination of fraternal and identical pregnancies and some may occur several days after a recent previous conception. This is 32-year-old Jennifer, a month ago her body produced one egg which was fertilized, then the egg divided and identical twins were formed, but the story does not end there. Her body produced a second egg. She was also impregnated. In the uterus, an identical twin was joined by a 3rd fraternal twin; this is the so-called superfecundation, translated from Latin as additional fertilization, an extremely rare phenomenon. In Jennifer's case, the second egg was fertilized with sperm remaining from previous sexual intercourse, but this does not always happen. Formally, each egg can be fertilized by sperm from two different ejaculations and even from two different men. It has been established that for every 400 fraternal pregnancies, there is one with two twins from different fathers.

six weeks

Our three embryos are six weeks old and almost two and a half centimeters in size. The eyeball is 85 percent formed, and the lens of the eye begins to form. At this stage, the uterus can accommodate many embryos, a record of 15, but of these only 9 survived until birth. The scan shows us 5 fetuses that are only a few weeks old, although Jennifer's triplets were conceived naturally by superfecundation. The increase in the number of twins can be attributed to modern fertility treatments. In some cases, women take medications that stimulate the formation of many eggs, some of which are fertilized naturally through sex, in others, artificial insemination is used. Here, eggs are fertilized in a petri dish, then two or more are returned to the uterus. Since the introduction of infertility treatments in the late 1970s, the number of twin births has increased by 50 percent, and the number of 3rd and 4th twin births has increased by more than 400 percent.

8 week

The embryo is 8 weeks old. They grew up to three centimeters, which is the length of the phalanx of the thumb. The eyeball has formed, the lens of the eye is also almost formed, but the muscle that should focus it has not yet developed. It will be fully functional by the sixth month. After a couple of weeks, the fetus develops eyelids. The head is one of the first parts of the body to develop, it is large and makes up a third of the fetal body. It's as if a grown man had the head of a grizzly bear. At the time of birth, it will still make up a quarter of the child’s body; the rest of the body will reach proportional size only in adolescence. The embryo begins to resemble a small person; now it is called a fetus.

Week 9

By the ninth week, the brain begins to develop rapidly, with an average of two and a half million nerve cells being formed per minute. By the time of birth there will be 100 billion of them, but for now the baby’s body begins to twitch. These are involuntary reflex spasms not yet controlled by the brain. They play an important role in stimulating muscle growth and strengthening joints. The heart also becomes active. Starting after a three-week development of seventy-five beats per minute, by 9 weeks it gradually increases the frequency of contractions to 165, this is the maximum heart rate. In the last stage of pregnancy it will decrease to 125-150 beats. A child's heart beats at a speed of 70 to 110 beats per minute, an adult's heart beats at a speed of 70 to 80 beats per minute.

Our twins, triplets and quadruplets have no idea about each other's existence in the womb. However, they are already influencing each other. During every multiple pregnancy, there is competition for resources. In the case of fraternal twins, this rivalry is limited, since each of the two twins has its own chorionic sac and therefore its own placenta. But identical twins, most of whom share a common chorion, begin an unconscious struggle. Everyone needs to get the most nutrients, but the amount of nutrition is limited. At birth, one twin almost always weighs more than the other, depending on the efficiency of the placenta. As children grow older, this difference smooths out.

Our embryo is already 10 weeks old, a quarter of the way through development. Until now they have lived in the secret world of the female womb, soon mothers will see the tiny creatures they carry within them and some women will be quite surprised. We don't suspect that many of us could become twins.

Between 10 and 14 weeks of pregnancy, women have their first scan. Ultrasound has revolutionized our understanding of fetal development. This image was obtained using ultra-high frequency sound waves, so high that we cannot hear them. The umbrella directs ultrasound into the mother's body, sound waves penetrate soft tissue but are reflected from denser formations such as bones. Based on the characteristics of the reflected waves, the computer creates an image of the hidden fetus. Previously, we received a regular two-dimensional image, today, thanks to new technology, we can see three-dimensional images and compose those time sequences, producing a so-called four-dimensional scan. This scan makes it possible not only to obtain data on the size of the fetus from the state of its health, with its help many mothers find out for the first time how many children they are carrying 1 or more. Ultrasound scanning (ultrasound) reveals another secret to us; many of us do not know that we spent the first months in the womb with one or more neighbors who disappeared before birth.

This scan taken at 12 weeks of pregnancy shows 2 fetuses developing in the uterus. But we see places for three fruits, in that there was a 3rd fruit on the right. Four weeks ago it developed like the others and then disappeared, gradually diminished and was again absorbed by the uterine mucosa. This is the so-called vanishing twin syndrome. Scientists believe that the reasons for this are chromosomal abnormalities or insufficient nutrition coming from a depleted placenta. Nature sacrifices one or more fruits so that you can live others. Some mothers know that they were carrying missing twins because they see it on the scanner screen. Others discover this during childbirth when they see a clump of fibrous tissue in the placenta. But many mothers, like their born children, will never know about this. Many of us find it surprising that twins can disappear, but what is even more surprising is how often it happens. Some scientists estimate that 21 percent of fraternal twins lose a sibling. In the case of identical twins sharing a placenta, this number rises to 50 percent. There is even an opinion that every 8 people began their lives with a twin who disappeared in the womb. Moreover, scientists can now identify signs that point to those of us who have lost twin brothers or sisters.

Sometimes identical twins are born known as mirror twins, they are not a copy but a mirror image of each other so if one of them is right-handed, then the other is left-handed. Mirror twins are formed when the egg splits late, 9 days after conception, when its left and right sides have already been fixed. In rare cases, even internal organs are located in a mirror image. One twin has a heart on the left and the other on the right. The fact that left-handers are more common among twins suggests the surprising possibility that some left-handers may be the surviving half of a pair of twins.

Identical twins, multiple twins and mirror images of superfecundation are all important lessons that explain how we develop and are born. Among them, one stands out which belongs to the most unusual type of twins, these are Siamese or conjoined twins. There are two explanations for the appearance of conjoined twins. According to one of them, the egg does not separate completely due to the onset of separation too late. According to the second, separation begins early, but the developing embryos are somehow attracted to each other and grow together. The second assumption has more supporters; an interesting fact testifies in its favor. In the body of each of us there are small adhesive molecules that act like a kind of Velcro fastener, as our organs and body parts develop in the uterus, two arms, two legs, the right and left side, our aggressive molecules connect these two parts and create a proportional and symmetrical formation. The molecule is programmed to attract only similar organs and parts of the body, hand to hand, the left side of the face to the right, and so on. Conjoined twins have identical body parts fused together: head to head, chest to chest, waist to waist, as if in a mirror image. This suggests that the aggressive molecules of each child confuse their body with that of their neighbor and the two embryos literally merge.

End of the first trimester

We are approaching the end of the first trimester, our fetuses are beginning to look like children for the first time and are beginning to behave in ways they have not behaved before. As we approach the end of the first trimester pregnancy milestone, our fetuses have grown from an egg smaller than a grain of sand to a fetus the size of a fist, they are becoming human-like. An ultrasound scan after 12 weeks will delight parents as they will see the face of their unborn child. They grow and become stronger, the risk of miscarriage has decreased significantly. Although, according to statistics, in the case of twins sharing a common placenta, this risk is higher. While it is impossible to say whether the babies will be boys or girls, each fetus has a tubercle in the genital area, but it is not yet possible to determine the gender from it. Determining sex becomes a difficult task when many fetuses are developing in the uterus. It is even difficult for the scanner operator to determine which genitals belong to which.

At this stage, there is still plenty of space. Even the 4 twins are not touching yet, but this will soon change. The second trimester will be an important developmental stage for the twins, it is during this period of three to six months that they will make their first real movements. This will not be a twitch caused by the development of the nervous system, but the first manifestations of recognizing youthful behavior. Behavior that will lead them to first contact. The neural network has spread to almost all parts of the body, the brain can finally control the movements of the limbs. Nobody knows why the girls start to move first; they push and move sharply. In the case of a single fetus, these movements do not encounter resistance. If two or more brothers or sisters share, action leads to reaction. When one strikes, the other responds. When one pushes or touches neighbors, they respond in kind. According to scientists, the first model of the action of the response, which is clearly shown by four-dimensional ultrasound scanning, can play a positive role in accelerating the development of twins.

Beginning of the second trimester

At the beginning of the second trimester, our fetuses do not yet feel the presence of brothers and sisters who share with them the limited space of the mother's womb, but the situation will soon change. At week 16, the fetal movements become more complex, it begins to develop a sense of the surrounding space, and here the twin has an advantage over the single fetus. This is the sense of proprioception, the unconscious perception of the body in space. Later it will play an important role in a person’s life, helping to navigate our world. An adult receives information through different organs, eyes, ears, nose, and gets an idea of where he is. Thanks to this, we can coordinate our movements, stand without falling, run, jump and dodge solid objects. This sense of perception arises along with the first movements when the fetus first explores the space around it. For a single fetus this study is usually limited to two objects: its own body and the umbilical cord, but twins and more multiple twins have a wider choice. A small number of identical twins who share a common amniotic sac do not have such obstacles. You can see how they grab each other's hands, legs, umbilical cords and even faces. But even those twins who have separate amniotic sacs can interact easily. The amnion is very elastic and extremely thin. The thickness of its wall is no more than the size of two cells; four-dimensional scanning makes it almost indistinguishable. Despite this, the amnion is very durable. Having the thickness of a food wrapper, it is highly durable and is able to stretch and change shape as the fruit explores the surrounding space.

Week 19

There are 18 weeks left, half of the pregnancy. The stage is approaching when the fetuses begin to develop sensations. Their digestive system begins to work. Although they now receive the necessary nutrition from the placenta, which goes directly into their blood, from the moment of birth they will need to be able to swallow and digest food. Therefore, they begin to open their mouths and drink the amniotic fluid that surrounds them. The 4D scan clearly records their first attempts. The taste of food that the mother eats passes through the placenta into the blood of the fetus and is then excreted into the amniotic fluid. They sense taste and develop a taste bud on their tongue. Since, while in the womb of the mother, twins simultaneously feel the same tastes, in the future they may develop the same taste preferences. The sensation of the fruits develops quickly, they are ready to take advantage of them, twins and other twins growing in the womb are distinguished by special behavior. Scientists even observed them playing games together.

Week 20

This is the 20th week of pregnancy, the length of the fetuses is about 140 millimeters and they are so small that they can fit in the palm of the mother’s hand. Their eyes are still closed, but the main part of the eyeball has already formed, the iris is being formed, which regulates the amount of light entering the eye, but the pupil is formed just before birth. The fifth month, an important time for the formation of the nervous system, the number of nerve cells increases rapidly per minute, two and a half million neurons are formed. By the time of birth there will be 100 billion of them; now the main task is growth. However, this will soon become the biggest problem.

Until now, each of them has developed at about the same rate as an individual fetus, but soon they will face limitations - eventually there is simply no room in the uterus for two fully developed fetuses. A dilemma arises, none of them will benefit from the fact that the amount of nutrition is reduced and they themselves will remain small, on the other hand, by becoming too large, they can provoke premature birth, which can be dangerous for both of them. The speed of their development begins to gradually slow down. Now the condition of the mother and her fetus will be monitored by an obstetrician. He must ensure that they grow at the same rate and slowly enough so that by the time of birth all their systems are formed.

The uterus can accommodate a fetus weighing up to five and a half kilograms; usually the weight of one born child is from two and a half to five and a half kilograms, for twins from 2 to 3 kilograms, and for triplets from one and a half to two and a quarter kilograms. Each of the four or more twins born can weigh as little as a kilogram and require intensive care. Taller women have a more elongated abdomen so they can carry more weight. Jennifer, who is carrying triplets, is five feet tall and has a clear advantage over smaller women. Her physique will allow her to bear fruits longer, which is extremely important for their survival outside the mother's womb.

Week 25

24 weeks of development are behind us. The lungs produce surfactant that will allow babies to breathe after they are born. This is a mucous substance that allows the lungs to separate during inhalation. Since in multiple pregnancies the birth is almost always premature, doctors give the mother a steroid that helps in the formation of surfactant. The kids have grown up and are no longer captured together by a four-dimensional scanner. But this will be the first time their mothers will see them interact. The children are shown one at a time and in the image you can see the limb of one of the neighbors. A 4D scan shows one twin pushing the other. Even each of the fraternal twins, located in a separate chorion, feels like a neighbor is encroaching on his space. Although our twins and other twins are becoming increasingly close together, we will soon see an amazing manifestation of their prenatal activity and play. Moreover, they will play some of these games even after birth. In one case, scans regularly showed two ion-separated ovarian twins nestled cheek to cheek. When these twins were one year old, their favorite game was to stand on opposite sides of the curtain and laugh while touching each other through the fabric. According to scientists, their prenatal behavior carried over into early childhood. Twins who behave aggressively in their mother's womb can bring not only games but also their aggressiveness into childhood. The second case, a pair of twins, developed for approximately 4 months. One dominant twin was aggressive, the other was calmer and more compliant. Often 1 twin would push and hit 2, the calmer twin would pull away and hide his head in the placenta, like rocks of peace and protection. After birth, the twins maintained this pattern of relationships. At the age of about four years, when a quarrel broke out between them, the calmer twin would go into the bedroom and lay his head on the pillow.

These fraternal twins are positioned head to head at each other's feet and appear to be fighting. A 4D scan shows one twin hitting the other in the head. But these movements may not be as aggressive as they seem, this may be explained by their position relative to each other. Probably the twin on the left kicks simply because he is developing it, the twin on the right is possibly learning 1 valuable life lesson, he protects his face with his hand. The birth of twins is an accident. But identical twins provide scientists with an excellent opportunity to understand how we acquire character, abilities, and even intelligence.

The best time to travel during pregnancy is from about 14 to 26 weeks. During this period, all the organs and systems of the baby are formed, the placenta has formed and is functioning optimally, the tummy is not yet too large, most often toxicosis of the first half of pregnancy with nausea and vomiting is behind us, and the upcoming birth is not yet close, which is important for a comfortable rest. However, if the pregnancy is progressing normally, then you can travel during pregnancy, in principle, at any stage (of course, except for the last weeks of pregnancy). Before traveling while pregnant, be sure to consult with your doctor to make sure you have no contraindications for travel, and also to obtain a medical certificate, which may be required by some carrier companies.

Rule No. 2. When traveling during pregnancy, avoid sudden changes in climatic conditions

Currently, flights to warm regions, to the sea, palm trees, exotics, unusual routes, etc. are becoming very popular. As a rule, these are territories very remote from Russia, so you will mainly have to get there by plane and the flight there takes from 4 to 11 hours . This is a serious test for a completely healthy person. What can we say about the body of the expectant mother? The negative aspects of long-distance travel include a sharp change in climate (when the temperature difference can reach 40 ° C or more), difficulties in adapting both to new climatic conditions and to food, time zone, which can cause a decrease in the body’s defenses and subsequently lead to exacerbation of chronic diseases or an increased risk of respiratory infections in the expectant mother (this can happen both during vacation and after returning home against the background of a natural decrease in the activity of the immune system during pregnancy), the risk of catching some exotic infection, including and helminthiasis, taking into account the fact that before the upcoming trip, vaccination against many diseases is contraindicated for the expectant mother.

It is calmer and safer to go to countries with similar climatic conditions, for example, to Bulgaria, Croatia, France, Spain, the Baltic countries, or to visit beautiful places on our territory - Crimea, Valdai, Seliger.

When choosing a holiday destination, find out in advance about the weather conditions in the area so that the rainy season, extreme heat, seasonal winds or other similar natural phenomena do not become an unpleasant surprise when traveling during pregnancy.

Rule No. 3. Eliminate vacation options that are dangerous during pregnancy

During pregnancy, scuba diving is contraindicated; long excursions on foot or by bicycle, windsurfing, and mountain hiking are not recommended. In addition, you should not book excursions that involve sitting on a bus for many hours, which can also adversely affect the well-being of the expectant mother and the course of pregnancy. If you still have a strong desire to visit the sights, then choose short excursion trips and make sure that the days are not too busy. Give yourself some time to just relax and do nothing, especially in the first days after arriving at your vacation destination.

Rule No. 4. Evaluate the pros and cons of traveling while pregnant using different modes of transport

When choosing how to get to your vacation spot, you need to remember about the peculiarities of traveling on different types of transport, which can affect the health of mother and baby.

It happens that the only way to get to your destination is by plane – then there is no other choice. Traveling by plane during pregnancy, of course, significantly reduces travel time, but can become a serious test for the body of the expectant mother and baby. Therefore, you need to weigh the pros and cons when choosing a vacation spot. It should be remembered that during a flight during pregnancy, quite sharp changes in atmospheric pressure occur (this occurs during takeoff and landing), which can cause an increase in the tone of the uterus and blood vessels and lead to disruption of placental blood flow and premature placental abruption, especially if there are prerequisites for this ( for example, low attachment of the placenta) or rupture of the membranes with the development of premature birth. In addition, sitting in one position for a long time can adversely affect the blood circulation of the pelvic organs and legs. If the blood supply to the uterus deteriorates, this means that fetal hypoxia (oxygen starvation) may develop, which can affect the formation and maturation of the growing organism. Evidence of hypoxia can be both increased fetal movement and a decrease in its activity. Also, when sitting for a long time, the pregnant uterus presses the rectum to the pelvic floor, causing the vessels to be compressed, blood flow is disrupted and there is a high risk of developing or exacerbating hemorrhoids, varicose veins of the legs, and thrombophlebitis.

During pregnancy, the spine also experiences a lot of stress; this is also aggravated by a shift in the center of gravity in expectant mothers.

Traveling by train during pregnancy is the safest form of transport, but it is still advisable for the expectant mother to choose the most comfortable travel conditions (compartment or SV carriage). On the train you can lie down and relax comfortably, relieving the spine, as well as the vessels of the legs and pelvis (to prevent varicose veins and hemorrhoids).

During pregnancy, it is advisable to travel by bus or car over short distances, so that the travel time does not exceed three hours. What are these restrictions associated with? Firstly, a prolonged sitting position creates a large load on the spine, blood vessels of the legs and pelvis. Secondly, traveling by road is often accompanied by shaking, even when the road is in ideal condition (especially since the roads are not always in good condition), which can negatively affect the course of pregnancy and the general well-being of a pregnant woman. Thirdly, during such a trip the expectant mother may get motion sickness, which will certainly worsen her overall well-being and overshadow the pleasant impressions of the trip.

River and sea cruises can be quite comfortable for an expectant mother. However, they may hold a few surprises, especially for those who have never traveled this way. Most often this is motion sickness with nausea and vomiting, as well as fear of water. If before pregnancy the expectant mother tolerated this method of movement well, then most likely (with a normal pregnancy) there will be no surprises, but it is possible that the state of health will change not for the better. Therefore, if you are in an interesting situation, it is better to refuse such trips.

Rule No. 5. Maintain hygiene while on vacation during pregnancy

An expectant mother needs to take care of hygiene on vacation and while traveling. You should not drink raw water, it is better if it is bottled, you must wash vegetables or fruits, and do not try food on the street, especially in Asian countries, where dishes often use raw meat, fish and other seafood, generously seasoned with various spices (this may also provoke an exacerbation, the development of diseases of the digestive system or food poisoning).

Do not forget to wash your hands with soap or use wet cleaning wipes, preferably with an antibacterial effect or special antiseptic gels. Do not dry your hands with shared towels, but use sanitary paper.

It is advisable to wear shoes on the beach, since in many exotic countries (Africa, India, South America, Vietnam), helminthiases are common, infection of which occurs through the skin of the legs or other parts of the body in contact with the ground. For the same reasons, you should not swim in unknown bodies of water - choose specially designed and equipped places (for example, a hotel beach).

Rule No. 6. Take care of insurance and documents

Before traveling, a pregnant woman must take with her an exchange card and a doctor’s report, which should preferably be translated into English or another language used in the holiday country.

Before traveling, a pregnant woman must take care of insurance and carefully study what cases it covers and whether it includes complications during pregnancy. According to international rules, health insurance usually does not include cases related to pregnancy and childbirth (although in some countries it is valid for up to 12 weeks). You should keep this in mind and provide an additional amount for unexpected medical expenses.

You should definitely discuss your future trip with your gynecologist. Contraindications for long-distance travel include exacerbation of any chronic diseases, including allergic ones, problems with the formation or functioning of the placenta, for example, its low location, fetoplacental insufficiency, risk of uterine bleeding, threat of miscarriage, preeclampsia, multiple pregnancies, miscarriages or premature births in past.

Rule #7: Avoid overvoltage

Being in an interesting position, expectant mothers are subject to emotional swings and fatigue, and rest should be enjoyable. So you shouldn’t force yourself to go, for example, on an excursion or shopping, if you don’t have the desire and strength, you should listen to your feelings and emotions. It is also not recommended to plan your days too busy: of course, new experiences are necessary for a good rest, but you shouldn’t get carried away, because you can quickly get tired of spending too much time and changing pictures will no longer bring joy.

Rule #8: Don't lift heavy objects during pregnancy.

While expecting a baby, pregnant women are not recommended to lift heavy objects, so it is better not to take bulky and heavy luggage with them. If there is no way to avoid this or the expectant mother goes on a trip without a man’s shoulder, then bags and suitcases should be on wheels, with long handles, and even in this case they should not be heavy. At the train station and at the airport you can use the services of a porter, and at the hotel do not refuse the help of a porter.

How to avoid motion sickness?

When traveling by any type of transport, the expectant mother is not immune from motion sickness, even if the woman has not previously suffered from this ailment. Motion sickness is a vestibular disorder that occurs when a person moves on any type of transport and is perceived as a feeling of lightheadedness, impending loss of consciousness, dizziness, instability, with possible nausea and vomiting, which sometimes brings only temporary relief. This condition most often develops due to the increased sensitivity of the vestibular apparatus and when there is a violation of the assessment of information received from it and the eyes to the brain. Such changes occur quite often during pregnancy. Other manifestations of motion sickness may be a change in taste, increased salivation with frequent swallowing movements, palpitations, increased blood pressure, sweating, paleness, less often redness of the skin, rapid breathing, headache, tinnitus, lethargy, drowsiness. Medicines against motion sickness are contraindicated during pregnancy, so you will have to use non-drug remedies:

When planning a trip during pregnancy, you should choose places where you are least likely to experience motion sickness. On water transport, you should book a cabin at the front or middle of the ship or on the upper deck. On an airplane - seats at the leading edge of the wing, and during the flight, a stream of air from the ventilation system should be directed towards your face. On the train, you should choose a window seat at the front of the car and sit facing the direction of travel. In a car there is a front passenger seat, and on a bus there are seats closer to the driver in the direction of travel;
while driving, you should try to concentrate your gaze on the horizon line or on a distant stationary object, and also look forward and not out the side windows;
You should not read while driving or use your mobile phone to play or read. While moving, the text is viewed from a different angle than in the normal state, and reading may cause deterioration;
It is better to keep your head motionless, leaning back in the seat;
during a boat trip, you should try not to look at moving objects;
before and during the trip, you should avoid fatty, spicy, smoked, salty or other “heavy” foods, milk, sweet carbonated drinks, as well as overeating, so as not to excessively stimulate gastric motility and the production of digestive enzymes, which can subsequently lead to nausea and vomiting. Before traveling on any type of transport, you should definitely have a small snack, since an empty stomach is more likely to cause nausea;
during the trip, it is also recommended to wet your palms, neck, temples and forehead with water;
To prevent motion sickness, regular lollipops, especially those with lemon or mint flavor, can help. You can also use lemon by adding its juice to drinking water or keeping a small slice in your mouth from time to time. You can take aromatic oils of ginger, pine or orange with you. They have antiemetic and tonic properties, so by dropping the oil, for example, on a handkerchief, you can periodically inhale it to prevent motion sickness.

you can purchase special pillows for the neck and lower back in advance so that you can get more comfortable;
during a flight or moving by other means of transport, you can take off your shoes, periodically rotate your feet, wiggle your toes to restore blood flow in the vessels and improve blood outflow, preventing the development of varicose veins, hemorrhoids, as well as impaired blood flow in the placenta;
if the trip is long, then it is advisable to get up and walk around the cabin of the plane or train more often; when traveling by car, you need to periodically stop, get out and do a light warm-up;
if you are prone to varicose veins, you can wear anti-varicose jersey (tights, stockings or knee socks).

Multiple pregnancy is a fairly rare occurrence, accounting for no more than one case in a hundred. As a rule, we are talking about twins, but sometimes three babies are born, and even less often – four or more. Pregnancy with triplets week by week has its own characteristics. We will talk in detail about how this process proceeds and develops later.

When is the likelihood of conceiving triplets particularly high?

Every year, obstetricians diagnose more and more cases of expectant mothers carrying several children at once. Such positive dynamics are associated with the active introduction of innovative technologies into the reproductive process. For example, there is a high probability of multiple pregnancy in those couples who resort to the IVF procedure. But there are other factors favoring this phenomenon:

hereditary predisposition. Most often, pregnancy with triplets is transmitted “inheritedly” along the female line of the family - from mother to daughter or through a generation (from grandmother to granddaughter);

age of the expectant mother. According to medical statistics, the likelihood of being pregnant with triplets is greater in women who are 35 years of age or older;

taking hormonal contraceptives. Taking such drugs suppresses the ovulation process, and unplanned pregnancy does not occur. But after withdrawal, a reverse reaction is possible - ovarian hyperstimulation, which leads to the maturation of several eggs at once. Against this background, there is a high probability of a multiple pregnancy with twins or triplets;

infertility treatment. If there are problems with conception, the doctor may prescribe the woman to take medications that stimulate ovulation. This provokes the production of additional follicles in the ovaries and, as a result, increases the chances of pregnancy with triplets.

Signs that indicate triplets are expected

Pregnancy with triplets is no different from normal during the first trimester weeks. Only a screening study, which is carried out at 12 weeks, can clarify. It is not uncommon for only two fetuses to be visible during the first ultrasound, while the third is hidden behind them and may only appear on later ultrasound examinations. In the early stages, a gynecologist may suspect pregnancy with triplets based on a number of symptoms:

a pregnant woman gains weight very quickly;

the normal concentration of “pregnancy hormone” (hCG) at this stage is increased;

there is a discrepancy between the size of the uterus and the term;

excessively large abdominal girth.

The expectant mother can find out about a pleasant surprise on her own: a pregnancy with triplets at 20–22 weeks or a little later reveals itself by the active movements of several babies.

How does pregnancy with triplets proceed?

Pregnancy with triplets is carefully monitored by specialists week by week. If the expectant mother does not have any problems, she visits the doctor managing her condition every two weeks. Starting from the third trimester, you should visit your obstetrician-gynecologist's office weekly. According to indications, the specialist may increase the frequency of visits.

This is important! During a multiple pregnancy, the female body faces a colossal burden. This increases the likelihood of complications. Therefore, expectant mothers expecting the birth of several children should pay increased attention to their well-being. If your health worsens, you should immediately seek medical help.

There is a high probability that triplets will be born ahead of schedule. Both the expectant mother and medical specialists should be prepared for this. Therefore, if there is a pregnancy with triplets, 2 weeks before the expected date of birth, the woman is usually sent to hospitalization in the gynecological department at the maternity hospital for observation.

The main stages of pregnancy with triplets

First trimester

Pregnancy with triplets in the weeks of the first trimester is not much different from the process of carrying a single fetus. A woman can be informed that a new life has begun by symptoms typical for this period: toxicosis, increased sensitivity to certain odors, drowsiness. If a pregnancy with triplets develops normally over the weeks, the babies grow actively. So by the end of the first trimester, the expectant mother’s tummy becomes noticeably rounder. By this time, the placenta is already fully formed, and the fetuses are securely attached to the walls of the uterus. An ultrasound scan can already establish the fact of a multiple pregnancy.

Second trimester

Pregnancy with triplets is usually already diagnosed at this point. Babies begin to become more and more active, although the woman may not feel their very first movements. Nausea, dizziness and other ailments that accompanied pregnancy with triplets in the weeks of the first trimester gradually disappear. The belly of the expectant mother of triplets continues to actively grow. Its size is visually greatly increased compared to a singleton pregnancy. If an ultrasound reveals a shortened cervix, there is a risk of premature birth. In this case, a specialist who monitors the pregnancy of triplets week by week may recommend the installation of a pessary.

Third trimester

A woman pregnant with triplets may experience unpleasant symptoms such as heartburn and shortness of breath. This is a natural result of fruit pressure on the diaphragm, which makes digestion and breathing difficult. By the middle of the third trimester, the crumbs in the mother's belly are considered viable, so premature birth is no longer so scary. Most often, multiple pregnancies end earlier than usual. So, triplets can be born as early as 7–8 months. To avoid complications, doctors refuse to perform a natural birth and perform a caesarean section on the woman either planned or emergency (if contractions have already begun or the waters have broken).

If you find out you're expecting triplets, don't panic. Your calmness and balance are important for a successful pregnancy. Rest more, walk in the fresh air, eat well and enjoy life, because very soon there will be three more people dear to your heart.

A mother who gives birth to twins always has a special status. This is not surprising, because carrying and giving birth to several babies at the same time is a very difficult task. While carrying children, such a woman needs increased attention from relatives and doctors monitoring the pregnancy. Pregnancy with twins or multiple children has its own characteristics. By what signs can you find out about a multiple pregnancy, how do babies develop by trimester?

The main reasons for the development of multiple pregnancies (twins, triplets)

A multiple pregnancy is said to occur when several embryos are born and develop simultaneously in the mother's womb. The result of such a pregnancy is the birth of two, three or more babies. The record number of living children born as a result of one conception is 8 (USA, 2009).

Although it is typical for humans to have one embryo mature in the uterus, multiple pregnancies are not uncommon. According to statistics, one birth out of eighty ends in the appearance of twins, and every year there is an increase in this trend. Compared to the 60s, the incidence of twin births has increased by an average of 2.5 times.

This is due to the fact that various assisted reproductive technologies (artificial stimulation and in vitro fertilization), which are the causes of multiple pregnancies, are now more often practiced. Several other factors underlie multiple pregnancy:

simultaneous maturation of two, three or more eggs;
division of one fertilized egg into several parts;
genetic predisposition.

Some women give birth to twins and triplets more often than others. This ability is inherited through the female line, so if there are twins in the family, the chances of giving birth to several children at the same time increase.

Another factor is age. According to statistics, women who become pregnant after 30 years of age are more likely to have twins. To some extent, this is due to the fact that many of them, before conception, underwent a course of hormonal therapy, which promotes the maturation of several eggs. Women who give birth repeatedly, especially mothers of many children, also have a greater chance of conceiving multiple children at the same time.

Types of multiple births

Multiple pregnancy refers to the presence of several fetuses in the uterus. Among multiple pregnancies, twins are the most common, followed by triplets. Four or five children born at one time are quite rare.

Some twins are exact copies of each other, others not only differ in appearance, but also have different genders. What determines the degree of similarity or difference? There are two options for multiple conception:

The first occurs when several eggs mature simultaneously. This type of multiple pregnancy is called fraternal or heterozygous. As a result, children are born with different appearances. The gender may be the same or different.
The second variant of multiple pregnancy is the result of fertilization of a single egg, which turned into several separate embryos at one of the stages of division. Such children are called identical or monozygotic. They are always the same sex and very similar; without the help of their parents it can be quite difficult to distinguish them. The birth of identical twins is observed less frequently than fraternal twins.

What are the signs of a multiple pregnancy?

Are there any special signs that indicate a multiple pregnancy? Undoubtedly, such a pregnancy has its own characteristics. The woman herself may notice some of the signs of twins.

Features that an expectant mother may notice during a twin pregnancy:

very bright color of the express test strips (the reason for such intense coloring is a higher level of human chorionic gonadotropin);
clear signs of toxicosis (during pregnancy with twins, toxicosis develops from the first weeks, the symptoms are more pronounced);
the belly grows faster during pregnancy with twins;
active movement of babies.

During pregnancy with twins, there are also signs that can only be determined by a doctor during a routine visit to the antenatal clinic:

the beating of two or more hearts when listening;
location of several fetuses in the uterus during ultrasound;
the height of the uterine fundus exceeding the norm for a singleton pregnancy by an average of 5-10 cm;
high blood levels of human chorionic gonadotropin.

Fruit development

Fetal development during a multiple pregnancy goes through the same stages and lasts as long as a normal pregnancy. If twins are fraternal, they have different placentas. Identical twins have one placenta, from which several umbilical cords arise, connected to the fetus. Pregnancy with twins, corresponding to 12 weeks, and the development of embryos at this period is shown in the photo.

1st trimester

The first trimester is characterized by more severe toxicosis. The expectant mother may complain of severe morning sickness and frequent vomiting. The manifestation of these symptoms is closely related to the level of a specific pregnancy hormone (human chorionic gonadotropin), the level of which increases faster if there are several fetuses.

Unlike a singleton pregnancy, a woman notices an increase in the size of her abdomen early - she may already have a baby bump at 5-8 weeks. The rapidly growing uterus puts pressure on the bladder and causes frequent urge to urinate. The presence of several fetuses can be seen on ultrasound from 6-8 weeks of pregnancy. Women pregnant with twins are at higher risk of early miscarriage.

2nd trimester

As with normal pregnancy, the 2nd trimester begins at 13 weeks and is the most stable. Thanks to the body's adaptation to the new level of hormones, the signs of early toxicosis disappear.

In the 2nd trimester, the expectant mother feels the movement of the fetus in the uterus for the first time. Usually this moment comes a little earlier than during pregnancy with one child. After the 13th week, the belly is already clearly visible, the babies are growing. For their full development, a woman needs a balanced diet enriched with vitamins. By doing an ultrasound after 13 weeks, you can find out the sex of the babies.

3rd trimester

By the third trimester, the beginning of which corresponds to 28 weeks, the expectant mother faces additional difficulties due to her greatly expanded belly. It is much more difficult for her to move, she gets tired quickly. During this period, women may show signs of anemia and calcium deficiency, so you need to be very careful about your doctor's recommendations for nutrition and taking vitamins and mineral supplements.

Women with multiple pregnancies have an increased tendency to late toxicosis, the development of edema and increased blood pressure. In addition, there is a high risk of developing diabetes during pregnancy, but in most cases, after childbirth, carbohydrate metabolism normalizes.

Women carrying several children usually give birth a little earlier than their due date. This is due to the fact that babies are located more closely in the uterus and begin to experience a lack of free space early, so labor may not begin exactly according to the calendar, but several weeks earlier.

Features of the flow

What is the difference between singleton and multiple pregnancy? There are 8 features characteristic of carrying twins:

the most common age of women in labor with such a pregnancy is 30-40 years;
a woman pregnant with twins or triplets needs an increased daily dose of folic acid (1 mg versus 0.4 mg when carrying one fetus);
more frequent routine doctor visits during pregnancy;
severity of early toxicosis;
early sensation of fetal movements;
large weight gain in a pregnant woman;
high risk of developing preeclampsia and gestational diabetes;
early births and a high percentage of cesarean sections.

Management of multiple pregnancy and childbirth

A woman carrying several babies needs careful attention from an obstetrician-gynecologist and other specialists due to the high likelihood of various complications occurring during a multiple pregnancy. At the antenatal clinic, doctors monitor twin pregnancies week by week. During this observation, the expectant mother undergoes a number of planned activities, including:

scheduled visits to the gynecologist;
periodic examinations by an ophthalmologist, dentist, endocrinologist;
laboratory diagnostics depending on the period;
Ultrasound (modern equipment allows not only to calculate the timing, but also to take a photo).

What complications can there be for mother and children?

A woman carrying twins begins to experience increased stress from the moment of conception until childbirth. Doctors note a high risk:

early and late toxicosis;
bleeding and miscarriages in the 1st trimester;
development of anemia;
premature rupture of amniotic fluid;
premature birth.

There are also certain complications for children. These include:

intrauterine fetal hypoxia;
high risk of birth injury;
increased risk of newborn asphyxia and cerebral ischemia;
low weight and height of newborns.

Doctors take into account all possible risks and try to prevent complications from occurring. In situations where there is significant danger to the mother and child, obstetricians resort to caesarean section.

Maria and Anders Yestard decided to have a second child so that the eldest would have a sister or brother. After short attempts to conceive, the woman... Everything would be fine, but in the early stages the belly was larger than it should be. However, the couple was not very alarmed by this. For the time being.

But when Maria came for an ultrasound in the third month of pregnancy, a big surprise awaited her. It turned out that not one child was developing in her belly, but three. The couple were shocked - they wanted two children, not four. So much was not even in their plans for life. But, as you know, fate often makes its own adjustments.

It's amazing that this happened at all. Typically, multiple pregnancies (more than two embryos) are only possible if fertilization occurs using the method. If naturally, then the chance is extremely small - 1 case in 5 thousand conceptions. But there are always lucky ones, and the Yesterdas became one of them.

The girl decided not to keep it all to herself, but to create Instagram account, in which to publish photos and talk about your amazing pregnancy. Now he is followed by more than 210 thousand subscribers.

Every week the girl photographed her belly and wrote about the peculiarities of pregnancy at one time or another. Every week the belly became more and more huge. This surprised even the woman herself - under one of the pictures she wrote that she was surprised how he could hold on and not fall.