Carrying twins, triplets, or more? Congratulations! You’re embarking on an incredible journey, one that’s filled with extra love, extra cuddles… and yes, a few extra appointments, too. It’s completely normal to feel a mix of excitement and maybe a little overwhelmed, especially when it comes to the details of prenatal care for multiples.
Growth scans are a routine part of monitoring your babies’ development, and understanding what to expect can ease some of that anxiety. These scans provide valuable information, helping your healthcare team ensure everyone is thriving. They’re a window into your little ones’ world, offering reassurance and, if needed, guiding any necessary interventions.
Here's a tip that I found invaluable during my own twin pregnancy: pack a small bag of snacks and drinks for each ultrasound appointment. Scans can sometimes run longer than expected, and keeping your blood sugar stable will help you (and your babies!) stay comfortable.
What are Growth Scans and Why are They Important for Multiples?
Growth scans are specialized ultrasound appointments designed to monitor the growth and well-being of your babies in utero. They’re more common in multiple pregnancies because babies sharing the same womb can sometimes experience differences in their growth rates. Think of it like this: imagine trying to equally divide a pie between two or three hungry people – someone might end up with a slightly smaller slice! Growth scans help ensure that each baby is getting their fair share of nutrients and developing at a healthy pace.
These scans use ultrasound technology to measure various aspects of your babies’ growth, including their head circumference, abdominal circumference, and femur (thigh bone) length. These measurements are then compared to established growth charts for multiples. Don’t be alarmed if your doctor uses terms like “percentiles.” It’s just a way to compare your babies’ measurements to the average range for their gestational age.
For singleton pregnancies, growth scans might be ordered if there's a concern about the baby being too large or too small. But in multiple pregnancies, they are usually scheduled routinely, often starting around the second trimester (around 20-24 weeks) and continuing until delivery. The frequency of these scans will depend on your individual circumstances and the type of multiple pregnancy you have (e.g., whether your twins share a placenta or have separate placentas).
Ultimately, the goal of growth scans is to identify potential problems early on, such as twin-twin transfusion syndrome (TTTS) in monochorionic twins (twins who share a placenta), or selective intrauterine growth restriction (s IUGR), where one twin is growing significantly slower than the other. Early detection allows your healthcare team to intervene promptly, potentially improving outcomes for your babies.
Do twin pregnancies always mean more ultrasounds?
Generally, yes. Because of the increased risk of complications, twin and higher-order multiple pregnancies require closer monitoring than singleton pregnancies. This often translates to more frequent ultrasound appointments, including growth scans, to ensure the babies are developing healthily.
What to Expect During a Growth Scan
The experience of a growth scan for multiples is similar to a regular ultrasound, but it may take a bit longer. The sonographer (the trained technician who performs the ultrasound) will apply a gel to your abdomen and then use a handheld device called a transducer to send sound waves into your womb. These sound waves bounce back, creating images of your babies on a screen.
During the scan, the sonographer will be meticulously measuring different parts of each baby. This can involve a lot of pausing, zooming, and taking precise measurements. Don’t be surprised if the sonographer is very quiet and focused during this process – they need to concentrate to get accurate results. They’ll be looking at each baby individually, so you might see them moving the transducer around quite a bit to get the best angles.
You’ll likely be able to see your babies on the screen, and the sonographer might point out different body parts. However, remember that their primary focus is on taking measurements, so they might not be able to provide a detailed commentary throughout the entire scan. Feel free to ask questions at the end of the scan, though, or ask your doctor about the results at your next appointment.
The length of the scan can vary depending on how cooperative your babies are! Sometimes, they might be in a position that makes it difficult to get accurate measurements, and the sonographer might need you to walk around, change positions, or even come back later. Don’t worry, it happens! Think of it as your little ones already showing their unique personalities.
After the scan, the sonographer will send the results to your doctor, who will review them and discuss them with you at your next appointment.
What questions should I ask during or after a growth scan?
Here are a few helpful questions: "Are the babies growing at a similar rate?" This is important for identifying potential growth discordance. "Are there any signs of Twin-Twin Transfusion Syndrome (TTTS) if they are monochorionic?" Understanding if there are concerns is key. "Are the amniotic fluid levels normal for each baby?" This can indicate how well each baby is doing. "When is the next growth scan scheduled?" Knowing the follow-up plan helps manage expectations.
Understanding the Results
The results of your growth scan will be presented in terms of measurements and percentiles. As mentioned earlier, percentiles are simply a way of comparing your babies’ growth to the average. For example, if a baby is in the 50th percentile for head circumference, it means their head circumference is about average for babies of that gestational age.
It’s important to remember that these are just estimates. Ultrasounds are not perfectly accurate, and there can be a margin of error. A single growth scan shouldn’t be interpreted in isolation. Your doctor will look at the overall trend of your babies’ growth over time, comparing measurements from previous scans to see how they are progressing.
Significant differences in growth between the babies, known as growth discordance, can be a cause for concern. The definition of significant discordance varies, but it’s generally considered to be a difference of more than 20% in estimated fetal weight between the babies. If growth discordance is detected, your doctor may recommend more frequent monitoring or other interventions.
Another important aspect of the growth scan is assessing the amniotic fluid levels around each baby. Too much or too little amniotic fluid can indicate potential problems. Your doctor will also be looking for signs of TTTS in monochorionic twins, such as differences in amniotic fluid levels between the sacs or discrepancies in bladder filling.
If your doctor has any concerns about the growth scan results, they will discuss them with you in detail and explain the next steps. This might involve more frequent monitoring, referral to a specialist, or, in some cases, early delivery. Remember that your healthcare team is there to support you and your babies every step of the way.
What if the Scan Shows a Problem?
Hearing that there might be a problem with your babies’ growth can be incredibly stressful. It’s natural to feel anxious and worried. The most important thing is to stay calm and trust your healthcare team. They are the experts and will guide you through the process.
If a growth scan reveals a potential problem, your doctor will likely recommend further testing to confirm the diagnosis and assess the severity of the situation. This might involve more frequent ultrasounds, Doppler studies (which measure blood flow in the umbilical cord and fetal blood vessels), or even an amniocentesis (a procedure to collect a sample of amniotic fluid).
Depending on the specific issue, there are various management options available. In some cases, simply more frequent monitoring is sufficient. In other cases, interventions may be necessary. For example, in cases of TTTS, laser surgery can be used to correct the abnormal blood vessel connections in the placenta. In cases of severe growth restriction, early delivery may be the best option to ensure the babies’ well-being.
It’s important to remember that even if there is a problem, many multiples pregnancies result in healthy babies. Advances in medical technology and prenatal care have significantly improved outcomes for multiples. Your healthcare team will work closely with you to develop a personalized plan that is best for you and your babies.
How can I prepare for an earlier delivery?
Preparing for the possibility of an earlier delivery when expecting multiples involves several key steps: Discuss the possibility with your doctor: Understand the signs and symptoms of preterm labor. Pack your hospital bag early: Include items for both you and the babies, considering they might need to stay in the NICU. Prepare your home: Set up a comfortable and functional space for the babies. Arrange for support: Line up help with childcare, household chores, and emotional support. Educate yourself:Learn about potential NICU stays and how to care for premature babies.
Taking Care of Yourself During a Multiples Pregnancy
While growth scans are an important part of monitoring your babies’ health, it’s equally important to take care of yourself during your multiples pregnancy. Carrying more than one baby puts extra strain on your body, so it’s essential to prioritize your well-being.
Make sure you’re getting adequate rest and nutrition. Eat a balanced diet rich in protein, iron, and calcium. Your doctor may recommend taking a prenatal vitamin specifically formulated for multiples. Stay hydrated by drinking plenty of water.
Listen to your body and don’t push yourself too hard. Rest when you need to, and don’t be afraid to ask for help from your partner, family, and friends. Consider joining a support group for mothers of multiples. Connecting with other women who are going through the same experience can be incredibly helpful.
Remember, you are doing an amazing job. Carrying multiples is a unique and challenging experience, but it’s also incredibly rewarding.
Growth scans are just one piece of the puzzle in ensuring a healthy pregnancy and delivery. Armed with this knowledge, I hope you feel a bit more ready and empowered for the journey ahead. Trust in yourself, trust in your body, and trust in your healthcare team. You've got this, Mama!