| If your pregnancy symptoms are earlier and more | | | | gestation, your uterus may feel more like 10 to 12 |
| pronounced than you'd normally expect, you may be | | | | weeks to your obstetrician. This may prompt a |
| carrying a twin pregnancy. However, only a health | | | | request for an ultrasound examination. |
| professional can tell for sure. | | | | 6. You are told that you have elevated levels of AFP. |
| 1. You just feel that you are carrying more than one | | | | AFP is one of the chemicals tested to screen for |
| baby. Some mothers of twins (or higher order | | | | Downs syndrome and spina bifida abnormalities. AFP |
| multiples) say that they knew right from the start | | | | levels are higher in twin pregnancies. |
| that they were carrying more than one baby. | | | | 7. Your health care provider hears two fetal |
| 2. You experience more nausea and/or morning | | | | heartbeats. Two separate heartbeats can be |
| sickness. If you are having more than one baby, you | | | | distinguishable with a Doppler in your care provider's |
| may have an elevated hCG level (hCG is a pregnancy | | | | office from around 18 weeks. At around 28 weeks, it |
| related hormone). This hormone is the one associated | | | | may be possible to differentiate two fetal heads and |
| with morning sickness. | | | | multiple small parts when doing an abdominal exam. |
| 3. Other typical pregnancy symptoms may be | | | | 8. You have a positive ultrasound. If you believe you |
| exaggerated. Many women -- but not all -- who are | | | | are pregnant with twins, an ultrasound can be |
| pregnant with twins have more intense pregnancy | | | | performed quite early in pregnancy. With a skilled |
| symptoms, probably related to the extra hormones | | | | ultrasonographer, two gestational sacs, two embryos |
| circulating through their system. You may find that | | | | and two distinct fetal heartbeats can be seen six |
| your breasts are extremely tender, you have to | | | | weeks after the first day of the last menstrual |
| urinate frequently, you are hungry all the time and | | | | period. Many twins have been diagnosed as early as |
| you are always very tired. | | | | five weeks -- when you're just one week late for |
| 4. A higher than average weight gain in the first 16 | | | | your menstrual period. |
| weeks may be your first clue that you're carrying | | | | 9. In later pregnancy, you may experience difficulty |
| more than one baby. Good weight gain in early twin | | | | catching your breath, swelling (oedema) of the hands |
| pregnancy is associated with a favourable outcome. | | | | and legs, an unusual rate of weight gain and |
| With each additional fetus a woman carries, the | | | | abdominal enlargement and excessive fetal |
| range of weight gain will increase. For example, a | | | | movement. Anaemia or low iron (decreased |
| woman who starts a pregnancy in a healthy weight | | | | haemoglobin) is also common with twin and multiple |
| range might expect her weight gain to be as follows: | | | | pregnancies. |
| One fetus, 11 kg (24 lb) to 16 kg (35 lb) | | | | 10. There is considerable disagreement among medical |
| Twins, 16 kg (35 lb) to 20 kg (44 lb) | | | | professionals as to whether a woman carrying twins |
| Triplets, 20 kg (44 lb) to 23 kg (51 lb) | | | | is more likely to feel movement earlier. But many |
| Quads, 23 kg (51 lb) to 25 kg (55 lb) | | | | mothers do claim that those early flutters and flips |
| 5. Your uterus seems large for gestational age. If | | | | were their first clue that they might be having more |
| your last menstrual period indicates an eight-week | | | | than one. |