Multiple pregnancy is a pregnancy with more than one fetus. Multiple pregnancies can run in the family but are more common when the mother is receiving fertility treatment. While many pregnant mothers with twins and triplets give birth to healthy babies, there are some increased risks associated with multiple births.
Failure to properly monitor a mother with multiple pregnancies can increase the risk of injury if there are birth complications. When a doctor’s negligence causes birth injuries to twins or triplets, the doctor may be liable for damages. If you have any questions about multiple birth complications, talk to a Philadelphia medical malpractice attorney for help.
Twins and Triplet Birth Complications
The most common multiple pregnancies involve twins. Twins are generally classified as fraternal or identical. When more than one egg is fertilized by sperm and more than one embryo implant in the womb, the two fetuses are fraternal twins. When a single fertilized egg splits into identical embryos, this creates identical twins. Fraternal twins are more common than identical twins.
Fraternal twins have two fetuses growing in the womb but there may be more embryos that implant, resulting in 3, 4, or more pregnancies at the same time. The terms for multiple births include:
- two births – twins
- three births – triplets
- four births– quadruplets
- five births – quintuplets
- six births – sextuplets
- seven births – septuplets
- eight births – octuplets
What Causes Multiple Pregnancies?
Multiple births are more common than they were in the past. One reason for the increase is the greater number of women having fertility treatments. Women are also giving birth at older ages, which also increases the chances of giving birth to twins.
During fertility treatment, doctors may place two or more fertilized embryos into the mother’s womb to increase the chances that the embryo will implant and develop into a fetus. Other fertility treatments stimulate the ovaries, which may release more than one egg at a time. With multiple eggs released, there is an increased chance that the eggs will be fertilized by sperm and develop into multiple embryos.
Common Complications Associated with Multiple Births
There are a number of possible complications associated with multiple births. This can present problems for the babies and the mother. Increased risks of multiple births include:
- Premature birth
- Low birth weight
- Intrauterine growth restriction (IUGR)
- Cesarean delivery
- Placental abruption
- Developmental disabilities
- Congenital health conditions
Premature Birth and Low Birth Weight
In multiple pregnancies, babies are more likely to be born early. In one study, premature labor in multiple pregnancies was 7 times higher than for single pregnancies. The average length for most pregnancies is about 38 weeks but the average drops to 36 weeks for twins, 32 weeks for triplets, and 30 weeks for quadruplets.
There is a greater risk of complications with lower gestation periods. Babies born before 32 weeks and babies weighing less than 3.3 pounds have an increased risk of health complications, including infection. Preterm delivery is one of the most common and serious complications of multiple pregnancies. Long-term complications can include hearing problems, cerebral palsy, vision loss, mental retardation, and developmental delays.
When a mother is aware of multiple pregnancies, the doctors should caution the mother of the risks of premature birth and help reduce some of the other risks of preterm delivery, including:
- Drug use
- Alcohol use
- High blood pressure
- Placenta previa
Intrauterine Growth Restriction (IUGR)
Intrauterine growth restriction or fetal growth restriction (FGR) is a condition where the baby is smaller than expected for the number of weeks of pregnancy. Energy and oxygen are vital for the growth of a child and any complications can delay growth or cause more serious birth injuries. When the baby is small because of delayed development, including underdeveloped organs and tissue, it can cause a number of problems.
Preeclampsia and Hypertension
Preeclampsia is a pregnancy complication that can lead to seizures, or eclampsia. Preeclampsia is characterized by high blood pressure and organ damage, usually in the kidneys or liver. If the complications are not controlled or get worse, delivery of the baby and placenta may be necessary to treat preeclampsia.
Gestational hypertension is also more common with multiple births. Women with multiple fetuses are more than 2 times as likely to develop hypertension during pregnancy compared to single births. Gestational hypertension can also increase the risk of placental abruption.
Gestational diabetes is the development of high blood sugar levels in a woman during pregnancy. Gestational diabetes is not uncommon and affects up to 10% of pregnant women. If it is not properly treated and monitored, it can increase the risk of birth complications.
Placental abruption is the premature separation of the placenta from the uterus. This pregnancy complication can put the mother and baby at risk of injury or death. The fetus may go into distress, which puts the baby at risk of hypoxia or oxygen deprivation. If the baby is deprived of oxygen for too long, brain cells begin to die and the child may suffer permanent brain damage. A risk factor that increases the chance of a placental abruption includes multiple pregnancies.
Multiple pregnancies are associated with a higher mortality rate. Stillbirth can occur in the weeks before the baby reaches full term and the shorter gestation period for multiple births may increase the risk of being stillborn.
Cesarean Delivery with Multiple Births
Cesarean delivery, or C-sections, are more common with multiple pregnancies. According to one study, almost half of multiple pregnancy cases were delivered by cesarean section. The reasons for c-section or emergency c-section delivery may include oxygen deprivation risk, difficult labor, fetal distress, and abnormal presentation.
Medical Errors and Multiple Birth Injuries
There are a number of risks involved in multiple births. Mothers who are pregnant with multiples should be followed closely by their doctors. The doctors should also closely monitor the fetal development and health of the fetuses. Preterm labor may also have health risks for the babies and should be treated timely. Failure to properly evaluate, monitor, diagnose, and treat the mother and babies in a multiple pregnancy may result in serious harm to the babies and mother, including the risk of death.
When a doctor fails to provide proper care, they may be committing medical negligence. Medical malpractice claims against a negligent doctor may allow the family to recover compensation to care for their child. This can include medical expenses, future medical care, educational and physical care, and pain and suffering.
If your child was injured during childbirth because of medical negligence, talk to an experienced birth injury attorney about your options for recovery. Do not hesitate to contact Gilman & Bedigian today for a free consultation.