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