Twin pregnancies occur when a mother’s body makes two embryos simultaneously. While this is often no cause for alarm, some mothers may be at increased risk for certain conditions and side effects during and after pregnancy that should be addressed with their obstetrician.

What are the Symptoms of Twin Pregnancy?

You may not experience any symptoms until your second trimester, when you will start to feel tired, begin gaining weight, and experience a change in bowel habits. The symptoms associated with a twin pregnancy can vary and come on more gradually than in a single pregnancy. The best way to know if you are carrying twins is to consult your OBGYN for an early scan.

What are the Risks of Twin Pregnancy?

Some of the risks of carrying twins are:

1. Preterm labor and birth

Preterm labor is the onset of signs and symptoms of labor before 37 weeks. Preterm labor can be triggered by an infection, reduced amniotic fluid, and problems with the placenta when carrying twins. Your risk of preterm labor increases because you have to spend more of your energy on two fetuses rather than the usual single fetus.

Preterm births often have normal outcomes, but do increase the risk of your child(ren) needing special treatment immediately after giving birth to ensure their optimal health.

2. Twin-to-Twin transfusion syndrome

When one twin receives too much oxygen in utero, the other can develop too little oxygen and become distressed. This is called twin-to-twin transfusion syndrome. It occurs in pregnancies with two fetuses but only one placenta, which means the twins (or multiples) are drawing from the same source of blood for development. Too much blood can lead to increased heart rate and blood pressure in a fetus, while too little leads to underdevelopment and other complications.

3. Increased risk of miscarriage

A woman is at increased risk of miscarriage if she has twins or carries multiples. Various studies have shown that women with twins are more likely to miscarry than those with singleton pregnancies, however, all studies have shown that the risk is still between 5-13%. Congenital disabilities are also more common in multiples when compared to singleton pregnancies.

4. Placental abruption

Placental abruption is a severe complication in a pregnancy where the placenta detaches from the uterine wall. It is possible to occur in all pregnancies although it is more common in pregnant women who are carrying twins due to their reduced amniotic fluid levels and increased pressure on the uterus.

5. Gestational hypertension

Gestational hypertension, or pregnancy-induced hypertension, can be defined as the development of abnormally high blood pressure during pregnancy. It is common in women carrying twins, especially when their fetuses share one placenta. The risk of developing this increases as your pregnancy progresses, and you will need regular monitoring to identify any problems early.

Learn More About Twin Pregnancies

The severity of risks of a twin pregnancy depends on your age and your overall health in addition to the fact that you have a multiple pregnancy. If you have twins in the family, you are more likely to conceive multiples naturally. Dr. Alex Tepper, MD, FACOG, is a New York City OBGYN specializing in helping women carry multiple pregnancies healthfully to term. Schedule a consultation with Dr. Tepper today to discuss your risk factors, options, and pregnancy care plan.


Whether you are a new or returning patient, Dr. Tepper can assess your concerns and discuss your options to find the most comfortable and convenient care for you. To get started, call our office to set up an appointment.