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Alt Text: twin pregnancy care risks delivery plan India Dr Mamta Agrawal BestGyno
Twin pregnancies are becoming increasingly common due to rising maternal age and fertility treatments. Carrying twins is a beautiful experience, but it requires special monitoring, diet care, additional scans and careful planning to ensure the safety of both mother and babies. As a Gynaecologist with 27+ years of experience, I guide many mothers with twin pregnancies through a smooth and safe journey.
This complete 2025 guide explains types of twin pregnancy, symptoms, risks, diet, scans, precautions, normal delivery chances and C-section guidance.
Types of Twin Pregnancy (Based on Placenta & Sac)
Knowing the type of twin pregnancy is very important because the care plan depends on it.
1. Dichorionic-Diamniotic (Di-Di Twins)
Two placentas + two sacs
Safest type, least risk.
2. Monochorionic-Diamniotic (Mo-Di Twins)
One placenta + two sacs
Higher monitoring needed.
3. Monochorionic-Monoamniotic (Mo-Mo Twins)
One placenta + one sac
Highest risk; needs intensive monitoring.
Symptoms of Twin Pregnancy
- Severe nausea and vomiting
- Rapid stomach growth
- Early fetal movements
- Extreme tiredness
- Higher hCG & progesterone levels
Ultrasound is the only way to confirm twins.
Risks Associated With Twin Pregnancy
Twin pregnancies carry slightly higher risks, but with proper care, outcomes are excellent.
- Preterm labour
- Low birth weight
- Gestational diabetes
- Preeclampsia
- Placental complications
- Increased nausea & vomiting
- Twin-to-twin transfusion syndrome (for Mo-Di twins)
Regular monitoring helps detect all these issues early.
Special Diet for Twin Pregnancy
Twins require more calories, proteins and micronutrients.
Daily Requirements
- Additional 600 kcal/day (vs 300 kcal for singleton)
- High-protein diet: dal, paneer, eggs, sprouts
- Healthy fats: nuts, ghee, seeds
- Iron-rich foods: spinach, beetroot, jaggery
- Calcium-rich foods: milk, curd, ragi
- Omega-3 sources
Important Supplements
- Folic acid
- Iron + calcium
- Vitamin D
- Omega-3
These prevent anemia and support fetal growth.
Essential Scans in Twin Pregnancy
Ultrasound schedule is more frequent for twins.
- Dating scan – 6–9 weeks
- NT scan – 11–14 weeks
- Early anatomy scan – 16–18 weeks
- Anomaly scan – 20 weeks
- Growth scans – every 4 weeks
- Mo-Di twins: scans every 2 weeks from 16 weeks
Exercise Recommendations
Safe activities include:
- Walking
- Prenatal yoga
- Breathing exercises
- Pelvic tilts
Avoid high-impact workouts and heavy lifting.
Warning Signs to Watch For
- Severe abdominal pain
- Bleeding or leaking fluid
- Severe headaches
- Sudden swelling (preeclampsia)
- Reduced fetal movements
- Regular contractions before 37 weeks
Normal Delivery or C-Section for Twins?
Normal delivery is possible when:
- First baby is head-down
- Good fetal growth
- No major complications
- Experienced obstetric team available
C-Section is recommended when:
- First baby is breech
- Mo-Mo twins
- Growth restriction
- Preeclampsia
- Placental problems
Each case must be individually evaluated.
How to Prepare for Twin Delivery
- Discuss birth plan early
- Monitor fetal growth frequently
- Start iron + calcium regularly
- Eat every 2–3 hours
- Avoid long travel
- Ensure easy access to hospital
WHO Recommendations for Twin Pregnancy
- More frequent antenatal visits
- Early identification of complications
- Delivery in well-equipped centres
- Early management of preterm labour risks
Authoritative External Links
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Frequently Asked Questions (FAQ)
1. Are twin pregnancies always high-risk?
Not always, but they require extra monitoring for safety.
2. Can twin pregnancies be delivered normally?
Yes, if the first twin is head-down and no major complications exist.
3. How much weight should I gain in a twin pregnancy?
Usually 16–20 kg depending on your pre-pregnancy weight.
4. Do I need more scans than a singleton pregnancy?
Yes. Twins require more frequent ultrasound monitoring.
5. Are twins always born early?
Many twins come early, but good monitoring helps prolong pregnancy safely.
