Twin pregnancy # 1 – You just feel you’re carrying more than one baby. Don’t disregard intuition or dreams. Some mothers of twins (or higher order multiples) say that they knew right from the start that they were carrying more than one baby.
Twin pregnancy # 2 – You experience more nausea and/or morning sickness. If you are having more than one baby, you may also have an elevated hCG level. Higher levels of hCG also make it more probable that you will have bouts of morning (or all-day) sickness.
Twin pregnancy # 3. Other normal pregnancy symptoms may be exaggerated. Many women — but not all — who are pregnant with twins have more intense pregnancy symptoms, likely due to the extra hormones circulating through their system. You may find that your breasts are very tender, you have to urinate often, you are hungry all the time and you are very tired. In the second trimester, you may experience difficulty catching your breath, swelling (edema) of the hands and legs, an unusual rate of weight gain and abdominal enlargement and extreme fetal movement. Anemia or low iron (decreased hemoglobin) is also common with twin and multiple pregnancies.
Twin pregnancy # 4. You gain weight rapidly in your first trimester. A higher than average weight gain in the first trimester may be your first clue that you’re carrying more than one baby. If you’re eating well, don’t be concerned:
# 5. You are told that you have elevated levels of AFP. Levels of alpha fetoprotein (AFP), a protein released by the baby as it grows and found in the mother’s blood, can be elevated when there is more than one baby. (It can also be elevated for other reasons, such as neural tube defects.) Normally this simple blood test is given 16 to 18 weeks after your last menstrual period. Alpha fetoprotein testing detects over half of all twin pregnancies.
# 6 You are told you have rapidly rising hCG levels. Human Chorionic Gonadotrophin (hCG) is a hormone produced by the fertilized egg and by the chorionic villi. It is needed to maintain the pregnancy until the placenta develops. It can be detected in your blood or urine even before you miss a period. Normally in a singleton pregnancy, blood (serum) concentrations of hCG rise rapidly during the first weeks, doubling every two to three days. Levels of hCG can be even higher with twin or multiple pregnancies.
# 7 . Your provider hears two fetal heartbeats. Two separate heartbeats can be distinguishable with a Doppler in your care provider’s office by around 12 weeks. At around 28 weeks, it may be possible to differentiate two fetal heads and multiple small parts when doing an abdominal exam.
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