Fetal egg twins. Pregnancy with identical twins. When to learn about twins

With the simultaneous birth of two or more children at once, many myths and legends have long been associated with almost all peoples. And this did not happen by chance. After all, multiple pregnancy (twins) was often accompanied by various complications already in the process of its development, as well as postpartum problems. Currently, modern medicine is making every effort to maximize the safety of embryos and keep them alive. However, whatever the case with two or more embryos, he will need attention not only from the expectant mother, but also from the doctors.

Why do 2 fetal eggs develop in the uterus?

One of the most common types of multiple births is the conception and birth of twins. It develops as a result of one of two possible processes:

1) the simultaneous entry of different spermatozoa into two eggs and their fertilization.
2) the development of two zygotes from the same egg.

In the first case, the result of separate fertilization is two completely independent zygotes, and the type of such pregnancy is called "bizygotic". This type includes about 65% of all multiple cases.

In the case of the separate development of embryos, twins can be called according to characteristic features as follows:

• Monozygous (developing from the same zygote).
• Bihoral (has two placentas).
• Biamniotic (has two fetal bladders at once).

Bizygote characteristics

Bizygotic twins are divided into 2 types:

• Multiple ovulation (when fertilization occurs within the same ovulation cycle) is due to some features of hormonal production. This feature is used for "in vitro conception", or in vitro fertilization. The reason for this ovulation is called the increased production of folliculin due to stimulating hormone (FSH).
• Consecutive fertilization of two eggs (without inhibition of the second process). The interval between the eggs entering the uterus will be about 28 days.

Despite the difference in weight and maturity, the birth of such children will occur at the same time. On ultrasound, 2 fetal eggs will become noticeable 28-35 days after the first (singleton) pregnancy is detected. As for the sex of future children, bizygotic twins can be of either sex, or different sexes.

The degree of likelihood of the formation of a bizygote is due to hereditary factors, most often it is transmitted to patients through the mother.

Characteristics and types of monozygote

The second case - the simultaneous development of two zygotes, or monozygous twins - still remains a mystery to specialists. The monozygote, which has 2 fetal eggs, brings the greatest difficulties in the course of such a pregnancy. For reasons still unexplored, the zygote, reaching a certain period, forms two separate halves, quite suitable for life. One of these embryos will be like a mirror image (cloned copy) of the second.

Separation of the oocyte and the formation of monozygous twins usually occurs from 2 to 16 days after the fertilization process has taken place. At the same time, there are some features due to the day of separation:

• On days 2-3, each half will have full potential to develop independently inside the womb. 2 fetal eggs will be formed in the uterus, each of them will have its own chorion and amniotic cavity (fetal bladder).
• On days 4-7 - the cell mass for the development of the chorion and placenta will be separated from the cells that serve as the basis for the formation of the embryonic body. The separation will affect only the detached part of the cells. The twins will have a common placenta, but two separate amniotic cavities, and will be called monochorionic (one placenta, but 2 different bladders).
• On the 8-12th day - the separation process will affect exclusively the embryos. At the same time, they will have both the placenta and the fetal bladder, and it will be called monochorionic monoamniotic.
• On days 13-15, the separation will be incomplete, therefore, defects will be observed in the further development process. Embryos can grow together in any part of the body (for example, “Siamese twins).

Even cases where embryonic separation occurs on early dates, cannot be counted among normal processes. The frequency with which all kinds of malformations can appear will be much higher than in the case of a single fetus.

In embryos from monozygous twins, not only sex, but also the blood group, as well as the set of chromosomes, can be different. This may be due to:

• Pathology at the genetic level (chromosomal).
• Bookmark defects (due to external factors that influenced the first trimester - radiation, viruses, etc.).

To minimize the risks of developing defects and other defects that may affect the development of embryos, you will need not only constant supervision by qualified specialists, but also timely examination.

Features of diagnostics and monitoring of multiple pregnancies

Today, ultrasound diagnostics (ultrasound) makes it possible to identify several fetuses already at the beginning of their development. In this case, one of two types of examination is used:

• TA scan (transabdominal) - through the anterior wall of the peritoneum.
• TV (transvaginal) - The scanner is inserted through the vagina.

In total, a triple examination is carried out, at various times:

• for 10-14 weeks;
• for 20-24 weeks;
• for 30-34 weeks.

Tragnvaginal ultrasound examination reveals fetal egg 2 mm (maximum 4 mm). This happens when menstruation is delayed for a period of 3 to 6 days, that is, much earlier than in the case of a TA scan.

As practice shows, 2 fetal eggs become clearly visible by the fifth or sixth week. After that, embryonic bodies are gradually formed, and their heartbeats can be fixed. Over time, when the gestational age becomes more significant, it is possible to establish the exact number of placentas, the absence or presence of septa separating the membranes, and also to indicate the dynamics of development of all fetuses. All these data help the doctor determine the timing of fetal growth. At the same time, the most close attention is always paid to the search for pathological abnormalities.

If the development of both fetuses proceeds normally, they will have similar features to the development of one fetus before the period of 30-32 weeks (with the usual type of pregnancy). The placental location of each of the fetuses will be of little importance. The most favorable are the bottom, as well as the anterior and posterior uterine walls. The lower the placenta is located, the worse the quality of its nutrition will be. it biological feature in order to avoid a central presentation, when the placenta will block the canal, excluding the possibility of a natural exit of the fetus during delivery.

After a period of 32 weeks, the rate of fetal development is slightly reduced. The maternal organism, however, will have significant loads. In addition to an increase in maternal body weight (about 30%), there is an increase in the volume of blood circulating inside the body (about 10%), with the same level of erythrocytes. This explains the manifestation of anemia.

Due to the accelerated increase in the volume of the uterus, the term of delivery in the case of multiple pregnancies often occurs earlier than expected.

General requirements for the course of multiple pregnancies

Compared to the development of a single fetus, the type of multiple pregnancy requires special attention. Its characteristic differences will be as follows:

• an increased level of requirements for the mother's body;
• special care throughout the gestation period (especially with the monochorionic type) of the surrounding medical staff;
• in connection with an increased risk of developing placental insufficiency or the development of preeclampsia, special preventive measures are needed, which begin already in the second trimester;
• the need for a full-fledged protein menu, the appointment of drugs that include iron, the intake of vitamin groups;
• selection of a perinatal center (for delivery) of only the highest category - it is likely that qualified neonatal resuscitation will be required.

Caesarean section, as a type of operative delivery, is used much more often for a multiple case than in situations with a single fetus.

Two cherished strips on the test, a high level of hCG - these are the cherished desires of a woman who has made a long journey to pregnancy. Some may have had to resort to ART. It would seem that now only to enjoy 9 months of their status and prepare for the emergence of a new family member. But, not everything is so rosy. In recent years, the tendency has been increasing that during the first ultrasound, a fetal egg without an embryo is found at an early stage of pregnancy.

General structure of the intrauterine organism

After natural conception or fertilization in a test tube and subsequent transplantation into the uterus, the embryo begins to attach to the endometrium - implantation occurs. In the process of complex reactions in the embryo, cell division continues, and their differentiation begins. From one part, the organs of the unborn child will be formed, and from the other, extraembryonic organs will be formed - amnion, chorion, allantois, yolk sac, placenta.

All these organs are called provisional, since in their essence they provide the embryo with the necessary nutrients, serve as precursors of the child's future elements, protect the embryo from any negative factors. Thus, the ovum, or as it is also called the fetal sac, is the embryo, membranes, yolk sac, other formed bodies and amniotic fluid taken together.

What is the difference between a fertilized egg and an embryo? As described above, the embryo is a constituent part of the ovum. In simple words, the embryo is literally in a sac, ovoid, oval in shape, from which it feeds. Thanks to him, the embryo can develop and remain unharmed.

What is a yellow sac in a fertilized egg? It is more correct to say not yellow, but the yolk sac (sac) - this is a special and very important temporary organ of the unborn child. It is a process on the ventral side of the embryo containing the yolk. In the early stages of pregnancy, it performs the functions of the liver, produces germ cells for the fetus, actively participates in metabolic processes and is further reduced by the end of the first trimester.

Definition of the concept of anembryony

Unfortunately, at a certain stage, the embryo itself may stop developing, while the fertilized egg will be present. At the same time, the woman retains or increases all the signs of pregnancy - toxicosis, swelling of the mammary glands, absence of menstruation, mood swings, even a pregnancy test continues to show two stripes.

Empty ovum or lack of embryo photo:

This is due to the fact that such sensations are directly dependent on hormones produced by the membranes of the fetus, other organs, or administered orally, for example, if in vitro fertilization was performed. Such a picture can persist for a certain time, a woman may not feel the absence of an embryo and no signs that fatal and irreversible changes have occurred inside her.

Determined this pathology, at the first ultrasound, at 5-6 weeks of pregnancy. If there is no embryo in the ovum on the monitor of the ultrasound examination apparatus, then the doctor diagnoses anembryonia. In some cases, it is recommended to undergo a re-examination at 7-8 weeks or track the dynamics of hCG. A doubly confirmed fetus without an embryo is a reason for termination of pregnancy.

It is not uncommon for such a phenomenon as anembryony of the second ovum to occur. This means that the woman could have twins. On the remaining embryo, the one that is measured does not have a detrimental effect, provided that the second has no pathologies.

Causes of anembryonia

The amniotic fluid without an embryo or the fetal egg, as anembryony is also called, is still not a fully understood topic. The reasons for an empty ovum without an embryo are varied, and sometimes it is very difficult for a doctor to establish a real picture of such a situation.

The main culprits, why there is a fertilized egg, but the embryo is not:

• most often these are genetic or chromosomal abnormalities of the embryo, a malformed embryo will not survive, according to the law of natural selection;
• transferred acute infectious diseases in the first weeks of pregnancy, which directly affected the embryo;
• radioactive or x-ray exposure;
• negative influence of alcohol, nicotine, drugs;
• hormonal disorders of a woman, directly affecting the development of the embryo.

An egg in the uterus without an embryo, although fertilized, is definitely a sign that the pregnancy has stopped. But, for the formulation of such a diagnosis and, accordingly, the appointment of further treatment, it is necessary to make sure that the pregnancy is correctly calculated.

A frequent reason why the ultrasound does not see the ovum is precisely the fact that the study is carried out too early, at a time at which it is virtually impossible to notice the embryo.

The answer to the question of whether the embryo can hide is not unambiguous. With sufficient experience of a specialist and good sensitivity of the ultrasound machine, the likelihood that for some reason the embryo was not noticed is small. For reinsurance, you can independently try to do a second ultrasound with another doctor, perhaps in a paid office, after waiting for a week or two.

Average growth rates and projections

In the absence of pathologies, the size of a normal ovum gradually increases. So, on average, at 4 weeks, it is possible to visualize the PO up to 5 mm, after 5 weeks the size is 6-7 mm. A significant increase occurs at 6-7 weeks, the size of the PO reaches from 11 mm to 16-17 mm, and already after 8 weeks, the normal ovum is clearly visualized and its diameter is 18-22 mm.

It is generally accepted that if the ovum grows by the time of 8-9 weeks, and the embryo is not visible, then the pregnancy will not end successfully. Until then, it is too early to make serious predictions. It is not correct to focus solely on PY growth. Since the ovum with anembryony grows for a certain time.

Does a fetal egg grow during a frozen pregnancy? In the early stages of pregnancy, with anembryony, the embryo grows by 1-2 mm and stops developing. This size is almost impossible to determine using ultrasound, even the widest resolution. At the same time, the PU itself can increase due to the fact that liquid continues to accumulate in it. Therefore, the answer to the question of whether a fertilized egg can grow without an embryo is positive.

In a situation where ultrasound shows that the yolk sac is an embryo, there is no more favorable prognosis. Perhaps the gestational age does not allow visualization of the embryo itself. Normally, the yolk sac is visible on ultrasound in the period from 6 to 11 weeks of pregnancy. Regarding whether there can be a yolk sac without an embryo, the answer depends on what is meant, there is no embryo under the phrase. If it is not visible, if it does not develop at the moment when the yolk sac has already formed, but its size is very small, then yes - such a situation may be.

If there is a corpus luteum, but there is no embryo (not to be confused with the corpus luteum of the ovary, it comes about the extraembryonic organ), then the likelihood that the embryo was simply not seen is quite high. Since, in fact, the yolk is obliged to feed the embryo in the first three months. One of the causes of anembryonia is underdevelopment, early reduction or complete absence of the yolk sac.

Action tactics

When anembryonic disease is diagnosed, the only treatment option is cleansing (curettage or vacuum aspiration). The main argument is that the delay of a non-developing organism in the uterine cavity is fraught with serious consequences for a woman. These procedures are unpleasant. On the same days, it is necessary to provide reliable psychological support to a woman, because the loss of even a still not fully formed embryo is a tragedy.

Can a fertilized egg come out on its own? Nature has laid down a scheme for self-cleaning of the body from "wrong" forms of life. Therefore, when the embryo freezes in the early stages, miscarriages often occur. Egg detachment begins gradually, the uterus pushes out the unwanted organism. But, with a reliable absence of an embryo in the PU, waiting for the body to cleanse itself is not worth it. As well as how to run after the first ultrasound for cleaning.

The option when there is a pregnancy, but there is no fetus, the so-called chemical pregnancy, with the absence of a fetus, is not a ban on further attempts to become a mother. According to statistics, most women who have once been in a situation if there is a fertilized egg in the uterus, but there is no embryo, after additional examinations they give birth normally.

Pregnancy 2 months after anembryonic disease is not recommended. The body does not have time to move away from stress. Experts advise starting the next attempt to give birth to a child 5-6 months after the scraping procedure. If anembryony is repeated, then this serves as a signal for a complete and thorough examination of both spouses. It will be necessary to pass a compatibility test for various genetic abnormalities that can provoke the development of an empty PU.

Another fairly common situation is when the embryo grows, but the fertilized egg is not. Doctors in this case threaten to terminate the pregnancy, since the embryo will be cramped in its shell, and it can freeze. Certain hormonal treatments may be needed to stimulate the growth of the POI. But often, the situation when the fertilized egg does not grow, evens out over time, after 1-2 weeks the bag begins to intensively make up for lost time.

Carrying out a pregnancy is a rather unpredictable job, especially recently. Influence of negative factors environment is just beginning to emerge. According to statistics, about 20% of all women are diagnosed with anembryonia. But, you should not despair and panic. It is necessary to soberly assess the situation, consult with several specialists and then make a decision.

Sometimes an ultrasound scan reveals that the ovum has a deformed shape.

Such a diagnosis does not always indicate an abnormal course of pregnancy and fetal development. Only in conjunction with additional factors can this become an indication for abortion. In addition, it all depends directly on the type of deformation.

The main reason for the development of deformation of the ovum is the increased tone of the uterus. There is a significant reduction in the walls along various reasons: stress, infection or inflammation, hormonal imbalance, disease internal organs etc.

To eliminate the pathology, agents are used that contribute to the relaxation of the muscles of the uterus (magnesium, magnesium, etc.). It is also important to stop completely sex life, avoid physical exertion and stressful situations. The patient is prescribed semi-bed rest and complete rest. Such measures make it possible to preserve the pregnancy, provided that the fetal heartbeat is heard.

Abnormal development of the ovum

In addition to deformation of the ovum, the development of any abnormalities is possible. Many of them are capable of provoking a miscarriage or fetal freezing. The most common anomalies are presented below.

Also, exposure to toxic substances or radiation can provoke the onset of pathology. To establish the exact cause, both partners need to undergo a complete examination. Testing for the presence of STIs, spermograms and the study of the karyotype are mandatory studies in this situation.

There are times when a similar pregnancy develops in a perfectly healthy couple. Then the chances to endure healthy child in the subsequent pregnancy increase sharply. However, before planning, it is important to take a break (about six months) and allow the body to rest and recover.

Children born as a result of multiple pregnancies are called twins. In addition, you can often hear the word "twins", which is colloquially called "dissimilar" twins.

How does it work?

Twins are of two types. Dizygotic (fraternal, non-identical) twins develop from two fertilized eggs. Moreover, in some cases, the simultaneous maturation of two or more eggs occurs in one or both ovaries. A third way of origin of fraternal twins is possible: the fertilization of two or more eggs that have matured in one follicle. Interestingly, sometimes the difference between the time of conception of dizygotic twins can range from several hours to several days. Fraternal twins are no more genetically similar than regular siblings; they are of the same sex and of different genders with approximately the same frequency.

Monozygous (identical, identical) twins are obtained by fertilizing a single egg with one sperm. Then the resulting zygote begins to divide as usual, but with an interesting feature: as a result of division, independent embryos are subsequently formed. The reasons for the development of this process by science have not yet been precisely established due to the complexity of the biochemical mechanisms that regulate cell division. Such twins are almost exact copies of each other, although, of course, there are still minor differences between them. Indeed, in the initially identical DNA of each embryo, different mutations can occur. The second reason for the differences is non-genetic influences, for example, the characteristics of the areas of the female uterus or the effects of other factors. Monozygotic twins are 5 times less common than dizygotic twins. Among monozygotic twins, boys predominate.

A separate topic is Siamese twins. This is the name of identical twins, who have grown together to varying degrees. The alleged reason is the late splitting of the embryo into independent forms. The later this happens, the higher the risk. Siamese twins are extremely rare. They are born once every 10 million births.

Many conceptions of twins do not end with birth. For every pair of twins born, there are 10-12 people who had a twin in the womb.

Can twins be scheduled?

Naturally - practically not. If pregnancy has already begun and the woman knows about it, then in any case it is impossible to change the course of events by any means, because in the process of fertilization information is laid about the unborn child, including whether he will be one or two of them.

But some factors still increase the likelihood of conceiving fraternal twins, while the likelihood of having identical twins is not associated with any hereditary and external factors and is constant - on average 3 per 1000 pregnancies, that is, 0.3%.

So, in women aged 35-39 years, the likelihood of such conception increases. The fact is that in the late childbearing period in female body the concentration of the hormone increases, which stimulates the maturation of the egg. Thus, several eggs ready for fertilization can ripen at the same time. It is also known that the duration of daylight hours affects the production of this hormone. Therefore, it is more likely to conceive twins in the spring, when the sun begins to noticeably warm up.

If the family already had twins, then the closer the generation in which this happened, the higher the probability of giving birth to fraternal twins. The tendency to give birth to fraternal twins is manifested only in women. Men from such families can pass this property on to their daughters, although in the offspring of these men themselves, an increased frequency of twins is not observed.

More often, several eggs mature in women with a short menstrual cycle - 20-21 days, as well as in women with abnormalities in the development of the uterus, for example, in the presence of a septum in the uterine cavity or a two-legged uterus (pathology of uterine development, in which the organ is not pear-shaped, but as if bifurcated).

In recent years, hormonal drugs that stimulate egg maturation and ovulation have been widely used to treat infertility and other gynecological diseases. As a result, a long-awaited pregnancy after many years of infertility often turns out to be twins or triplets! Successfully developing in vitro fertilization (IVF) technologies have also led to the fact that pregnancy with twins or triplets is no longer a rarity. Twins after IVF are always heterogeneous, often heterosexual, each with its own appearance and character.

The frequency of twin births is significantly higher during various social upheavals and wars.

When can you find out about twins?

Fifteen to twenty years ago, twins were recognized only during childbirth or not earlier than the 20th week of pregnancy. When recognizing multiple pregnancies, the following signs were taken into account.

The enlargement of the uterus with multiple pregnancies occurs faster than during pregnancy with one fetus, so the size of the uterus does not correspond to the gestational age. At the same time, a significant volume of the pregnant uterus does not correspond to the small size of the presenting head of the fetus. In addition, with twins, a deepening of the area of ​​the bottom of the uterus (saddle uterus) can be determined, the formation of which is associated with the protrusion of the corners of the uterus by large parts of the fetus; as well as a longitudinal depression on the anterior wall of the uterus, if the twins are in a longitudinal position, or the presence of a horizontal groove on the anterior wall of the uterus when the twins are transverse. Long time important for the diagnosis of twins was a clear definition in the uterus during obstetric examination of three or more large parts of the fetus (two heads and one pelvic end or two pelvic ends and one head). Equally important was the presence of two distinct heartbeat points in different parts of the uterus.

Today, ultrasound examination, already at the 5th week of pregnancy, can tell the expectant mother how many babies she can expect. In this case, the doctor on the screen identifies two "bubbles" of nascent life. It is interesting that such a find for a woman who hesitated between having or not having an abortion, in almost 100% of cases, persuades the expectant mother to maintain the pregnancy. An experienced doctor for up to 14 weeks of pregnancy can determine the type of twins (monozygous or dizygotic) by the thickness of the septum between the "bubbles".

To diagnose multiple pregnancies, phonocardiography is also used, with which you can register the heart sounds of twins not only in the last months of pregnancy, but also at periods of 20-22 weeks and earlier.

The price of double joy

As soon as the antenatal clinic doctor determines that the expectant mother is expecting twins, or even triplets, he enrolls her in the category of pregnant women with an increased degree of risk. This is due to the fact that women with multiple pregnancies have two or more times the risk of developing serious health problems compared with women who carry only one child.

Even with an uncomplicated multiple pregnancy, a woman may feel tired; already in the second trimester, shortness of breath appears, heart palpitations. This difficulty in the activity of the heart and lungs is associated with a significant displacement of the diaphragm by the bottom of the uterus, the size of which is larger in multiple pregnancies than in single pregnancies, while the load on the heart muscle increases three to four times. During pregnancy with several fetuses, the risk of arterial hypertension increases - an increase in blood pressure, varicose veins, deep vein thrombosis are more often noted. Naturally, professional physical activity, lifting serious weights is out of the question. Moderate exercise is ideal - hiking in the fresh air, swimming. While sitting, it is better to place your feet on a special stand or a low coffee table - this will serve as a preventive measure against varicose veins. A good bandage and special tights for "double" moms are also a must. Fast growth The uterus can outpace the skin's ability to stretch, so multiple pregnancies often cause stretch marks (tissue breaks). Special products for abdominal and thigh skin care help to reduce their appearance.

In women expecting twins, early toxicosis is often observed. This is due to the fact that the level of hormones in the blood is much higher than during normal pregnancy. In multiple mothers, such a formidable complication of pregnancy as gestosis, a condition in which all organs and systems of the mother are affected, and the fetuses suffer, more often and more severely. Gestosis is manifested by an increase in blood pressure, the appearance of protein in the urine, edema on the legs.

By the end of pregnancy, there is often an increase in the urge to urinate due to pressure from the uterus on bladder... Pregnant women often complain of heartburn and constipation. The volume of the stomach of the expectant mother decreases due to the compression of it by the stretched uterus. For this reason, you should divide your meals into six small servings. Despite the small volumes, the food should be balanced. For each "overweight" baby, 300 kcal, additional protein and calcium should be supplied. The expectant mother especially needs iron and folic acid, a lack of them leads to the development of anemia (a decrease in the amount of hemoglobin) in the mother and oxygen starvation in children. In addition to the diet, special vitamins for pregnant women and additional preventive intake of special iron preparations will come to the rescue. It is good if it is possible to keep hemoglobin not lower than PO g / l.

The most serious complication of multiple pregnancies is the risk of miscarriage. Double or even triple load on the uterus often leads to the fact that the uterine pharynx begins to open ahead of time. Sometimes, in order to bring a pregnancy to at least 36 weeks, you have to resort to special devices that prevent the cervix from opening, or to put a suture on the cervix, which is removed at 36-37 weeks. For the same purpose, the doctor may recommend expectant mother"Rest" in the department of pregnancy pathology at the maternity hospital at the time when miscarriages occur most often or premature birth... You should not refuse such an offer.

In case of fraternal twins, the frequency of intrauterine malformations is the same as in singleton pregnancies, and in case of identical twins, it is 2 times higher. The course of such a pregnancy is often complicated by a delay in the growth of one of the fetuses. The most pronounced degree of such a delay is observed in fetofetal blood transfusion syndrome (identical twins with one placenta feed on each other). In this case, the lives of both are in danger. Usually the difference in body weight between twins is small and is about 200-300 grams. With fetofetal blood transfusion syndrome, this difference reaches a kilogram or more.

Nevertheless, the overwhelming majority of multiple pregnancies go well up to 37-38 weeks, when labor begins. Usually, doctors at this time recommend hospitalization in a maternity hospital, the purpose of which is to examine the pregnant woman and determine the time and method of delivery.

Read about childbirth and the postpartum period in multiple pregnancies in the next issue of the magazine.

At 12 weeks on ultrasound, they saw that twins, monochorial, the 1st - ktr 64, in the 2nd ktr 69. At 20 weeks, the difference in fetal weight was 100 g 361/262. Doctors are afraid of the possible development of SFT (fetal transfusion syndrome). What percentage of the difference between them and will it really lead to the death of both fruits?

With monochorionic twins, the risk of developing fetal-fetal transfusion syndrome is very high. Therefore, as a rule, there is a difference in fetometry indicators, their condition and adaptive capabilities. Monitoring during pregnancy allows for a timely assessment of the condition of the fetus, without waiting for a critical condition.

One fetal egg was placed on an ultrasound scan at 3 weeks. HCG showed 5-6 weeks. On ultrasound at 13 weeks, 100% of the girl said back wall, and at 17 weeks said that one fetus is a boy on the front wall. I have identical monochoreal twin brothers. Could it be that two uzists in a hurry found different babies, but did not look for the second or did not notice.?!

At 13 and 17 weeks, the diagnosis of a single / multiple pregnancy is not difficult. Highly specialized ultrasound specialists of our center will be able to answer your questions.

Dee Dee has twins 24 weeks pregnant. On ultrasound, one fetus is developed in terms of time and size for 24 weeks and 1 day, and the second for 22 weeks and 3 days. Is this lagging the norm?

Unfortunately, it is impossible to answer your question without information about the size of both fruitlets in the period of 11-14 weeks, screening data for the first trimester and information about the state of the placenta, umbilical cord, the amount of amniotic fluid and the results of Doppler measurements of your babies. Or send the question again, indicating all the necessary data. Or make an appointment by calling the Unified Call Center: 8-495-636-29-46

18-19 weeks of pregnancy, did ultrasound: monoamnitic monochorionic undissociated twins. Do I have different sex children or same sex? How to understand this? What is this in general and can it threaten me with something?

Monoamniatic monochorionic twins mean that babies have not only one placenta for two, but also one amniotic cavity for two. In this case, the sex of the babies should be the same. Undissociated twins means that the babies are not separated, "fused" with each other (the so-called "Siamese twins"). In this case, the prognosis for the life and health of babies may be unfavorable. To clarify this serious diagnosis, it is advisable to conduct an expert ultrasound scan, and then consult a geneticist.

At the first ultrasound at a period of 7 weeks, the pregnancy is monochorionic biamniotic, and in the maternity hospital at 11 weeks, it is bichorial biamniotic. Due to the doctor's excitement about the reduction of the cervix, she did an ultrasound scan at 15 weeks and again put a monochorionic pregnancy. At the same time, the doctor was completely convinced that these were twins. At 19 weeks, they said that they could not see how many placentas. How to find out twins or twins? And is this possible on subsequent ultrasounds? The kids are same-sex, neither me nor my husband had twins in the family.

Most accurately, chorion (how many placentas) is determined in the first trimester, when the thickness of the amniotic septum and the presence of chorionic tissue between the membranes of the amnial cavities can be estimated. With an increase in pregnancy, these signs lose their significance and the determination of chorionicity when both placentas are located on the same wall becomes difficult. An indirect indicator of monochorionic twins is the same sex in both babies, but this option is also possible if there are two placentas. It will be possible to finally resolve the issue of twins after childbirth.

We are planning a pregnancy. In October, the ovarian cyst was removed. After laparoscopy, the doctor prescribed treatment: 3 injections of Zoladex, 3 months of drinking to Vizanne and Klayra. On the husband's side, his grandmother was twins, my husband had twin cousins, and there were no twins on my side. After taking the listed drugs and taking into account the husband's heredity, do we have an increased chance of having a multiple pregnancy?

If more than three months pass from the moment you stop taking the drugs until conception, then the effect of the increased risk of multiple pregnancies will come to naught. As for heredity, the likelihood of multiple pregnancies is increased, but insignificantly compared to the population.

The first day of the last menstrual period was April 27, my periods were always irregular, they were diagnosed with polycystic disease. Conception could have occurred on May 10, 11, 17, June 2 and 13. Considering the first day of the last menstruation, it should have been 9 weeks of pregnancy on June 29, but the embryo was not visible. HCG - 22000 (corresponding to 9 weeks gestation), said anembryonic pregnancy, suggested cleansing or pills. Is there a chance of multiple pregnancies? My father is a twin and I have twins from my grandmother. Could there be just a short period in which the embryo is not visible? Is hCG high because multiple pregnancies develop?

To clarify the situation, it is necessary to undergo a study in dynamics.

At 12 weeks of pregnancy by ultrasound: dichorial diamniotic twins, at 21 weeks: monochorionic diamniotic, at 24 weeks: monochorionic, the sex is the same. The consultation decided that the first ultrasound should be believed. How to be?

To determine chorionicity with twins, ultrasound of the early stages is the most informative, therefore it is better to focus on ultrasound at 12 weeks.

6-7 weeks of pregnancy by ultrasound, according to the last months - 9-10 weeks. Cycle 34-36 days, ovulation was late, on May 10 by ultrasound: fetal egg 18 mm, 1 embryo: CTE 4.7, heart rate 93 beats / min., Yolk sac 3.1 mm, 2 embryo: CTE 3.4, no heartbeat, yolk sac 2.8 mm, corpus luteum in the right ovary 15 mm. Could the second embryo be delayed in development, or does this mean that the second embryo froze? And isn't the heart rate low in the first embryo?

The heart rate of the first fetus is within normal limits. CTE of the second fetus (3.4 mm) corresponds to a period of less than 5 weeks. At this time, the fetal heartbeat may not yet be detected. The size of the embryos can vary significantly already in the early stages of pregnancy, so it is quite possible that the second embryo needs to grow up. To assess the growth rate of embryos and the presence of a heartbeat in both babies, it is advisable to repeat the ultrasound scan in 2-3 weeks.

7 weeks of pregnancy, multiple fetuses are called into question. On November 22, there was a spontaneous abortion, the period for menstruation is 8-9 weeks, according to ultrasound a few hours before the miscarriage, the ovum was 4-5 weeks in size After cleaning, they gave recommendations not to get pregnant for 6 months, but in February I found out about pregnancy, they wanted to do medication interruption, but the doctor dissuaded, I want to save the pregnancy. What is the likelihood that a frozen and spontaneous abortion will not happen again?

The causes of a frozen pregnancy are various - genetic, antiphospholipid syndrome, luteal phase insufficiency, viral infections... It is necessary to examine and adjust the taking of drugs, depending on the results obtained.

7 (obstetric) weeks of pregnancy, according to ultrasound: two fetal eggs, but one has an embryo and a heartbeat is heard, and the other is empty. Can the second egg be delayed with the development of the embryo, or is it already certain that it will dissolve?

Sometimes two fetal eggs are laid, in one of which the embryo develops, and in the second, the embryo is not laid. In the period of I screening at 11-14 weeks, it will be possible to accurately determine the number of embryos and how they develop.

One fruit and two bubbles, are they twins or twins? What is it?

Sometimes two fetal eggs are laid, in one of which the embryo develops, and in the second, the embryo is not laid. Judging by your data, you have a singleton pregnancy. The second "empty" fertilized egg has no effect on the development of the fetus.

The second pregnancy, 22 weeks, monochorionic diamniotic twins, the first was 5 years ago, she gave birth on time, the son - everything is fine. On a period of 21 weeks, one fetus froze. The gynecologist sent for an interruption, I refused, as I hope to endure the second until a viable period, for this moment the child is healthy, all indicators correspond to the term. What are our chances? What are the risks for a living child and for me? I am 27 years old.

With diamniotic twins, there is a chance of delivering a second child. But careful observation is necessary in dynamics, including ultrasound and Doppler. For you, the risks are similar to those of ordinary twins.

13 weeks of pregnancy, monochorionic diamniotic twins, one pathology of MVPD with CHD omphalocele. What happens in such cases? Is it possible to save a second healthy baby?

In theory, yes. But if a fetus with congenital malformation dies in utero, then this can negatively affect the formation of the second fetus and there may be secondary changes in it, including quite serious ones.

5-6 weeks of pregnancy, ultrasound identified one fetal egg with a size of GS-21.3 mm, and in it two yolk sacs of 4.2 mm and 4.4 mm. Does this indicate twins?

An ultrasound scan is needed in dynamics in 1-2 weeks, when it will be possible to determine the number of embryos and their heartbeat.

My first pregnancy came at the age of 19, twins, two girls. A spontaneous miscarriage occurred at 17 weeks. The second pregnancy came in 1.5-2 months, one fetus, gave birth to a boy at the age of 20. I did not have twins in my family, my husband had a twin grandmother, his mother and her sisters and brothers did not have twins, the children of her sisters and brothers also do not have yet. What is the likelihood that I will have more twins?

The likelihood is increased, but it is impossible to say in numbers.

At 7 weeks of pregnancy by ultrasound: two embryos in one fetal egg, fetal CTE of 9 mm, monochorionic biamniotic twins. On ultrasound at 9 weeks, another doctor did not see the second fetus. The CTE of the fetus during the ultrasound scan varied from 26 to 28 mm. Can the second hide behind the first? And why did the CTE change?

When measuring CTE, an error within 2 mm is permissible, we recommend a screening ultrasound scan for a period of 11-12 weeks to clarify the situation.

6 weeks pregnant. By ultrasound: in the uterine cavity there are two fetal eggs, in one of which a developing embryo with a heartbeat, in the second - the embryo is not visualized. Is there a possibility of fertilization of two eggs with a difference of several days? What is the reason for the development of the second embryo lagging behind the first? Does this mean a suspension in the development of the second egg?

Most likely, we are talking about a non-developing ovum. The death of the second fetal egg will not affect the bearing of the remaining baby.

4 weeks pregnant, a week ago, two fetal eggs were found in a private clinic. I did an ultrasound in another place, one fetal egg is 7.7 mm, the other is not seen. What could it be? Has it disappeared? Is it a doctor's mistake or a different quality of equipment? There were no allocations.

It is not uncommon for one of the fetal eggs to die early in pregnancy and dissolve.

First pregnancy, 7 weeks. Ultrasound at 4.4 weeks: signs of a two-egg uterine pregnancy in one ovum and anembryony in the second. Now what to do with the second frozen egg? Should it be deleted or will it "come out" by itself? What will happen now with a normally developing ovum? I am 27 years old.

There is no cause for concern. The dead ovum will dissolve without harm to the remaining one. We recommend that you repeat the ultrasound scan to clarify the situation.

I am pregnant with twins. Is biochemical screening informative?

The first day of the last menstrual period is December 2, the average cycle time is 28 days. The first ultrasound scan on January 4: a fetal egg of 3 mm was detected in the uterine cavity, the corpus luteum was not identified. On January 5, the result of the analysis for hCG is 4471.0 mIU / ml. At the 11th week of the obstetric term, I found out that I have twins. Is it possible not to see twins at 4 weeks of obstetric term? Is it possible to conceive two babies in such different terms?

At a very short time (as in this case) it is quite possible not to see the second ovum. And if we are talking about identical twins, then they can be seen only when the embryos are well visualized.

At the first ultrasound, the doctor did not see the ovum, he set a period of no more than two weeks, the result of hCG on the same day was twice as high. Two weeks later I came to register with another doctor, the doctor examined it without an ultrasound, set the deadline for 8 weeks. At 12 weeks, at the screening, they wrote that one fetal egg and one fetus. Could not see the second baby on the ultrasound or is it impossible?

12 weeks of pregnancy, the ultrasound said that one embryo froze at 9-10 weeks, and the second is developing well. What is the likelihood of carrying a child? Will there be no infections from the dead fetus?

The likelihood of carrying a child is good enough. With a frozen fetus at this stage of pregnancy, it can dissolve without damage to the second fetus.

I did IVF. Last menstruation on April 10, puncture on April 28, postponed on April 30. The result of hCG on May 14 is 403. How long can a multiple pregnancy be detected? When to do an ultrasound? The doctor recommended on June 11, and the doctor who performed IVF on May 25.

Is it possible with a multiple pregnancy at the same time the ectopic development of one fetus and the fading of the second? How will the ectopic fetus develop if the frozen one was removed? although it was clear from the condition of the pregnant woman, as well as the size of her uterus, that the fetus had died?

The existence of a uterine and ectopic pregnancy is possible at the same time. Ectopic pregnancy will develop up to the rupture of the fruit receptacle. It is important not to allow this, but to carry out preventive surgical treatment with minimal health consequences.

In the 6th week, I had identical twins. One 5.7 mm, the other 6.2 mm. The first has a heartbeat of 154 beats / min, the second - 156 beats / min. Now I have 11 weeks. Can one of them "disappear" by this time?

In some cases, in the early stages, one twin fetus may stop developing, which can lead to its "disappearance".

By my calculations, I have three weeks and three days of pregnancy. Menstruation was from September 21 to 26. I know I got pregnant on October 9th. Everything was planned. She began to drink vitamins with folic acid in early September. On October 31, I passed the analysis of hCG - 19795. On the same day, I did an ultrasound scan, which showed 5 weeks and six days. Can an ultrasound doctor make a mistake and not see a multiple pregnancy, but put a longer term?

In the conclusion of the ultrasound, the obstetric gestational age is indicated, from the first day to the last menstruation. You count from conception, the true time. It will not be useful to anyone except you. All terms (decree, childbirth, etc.) are considered in obstetric weeks... Details on calculating the timing of pregnancy are written in the articles on our website.

My grandmother on my father’s side had twins, and my grandmother’s husband on my mother’s side had twins twice, I have two sons and I am currently 4 weeks pregnant, can I have twins?

Given your pedigree, you are more likely to have twins compared to the population frequency. On the ultrasound, everything will be visible.

I went for an ultrasound at 16 weeks of pregnancy, everything was fine. But when I came for an ultrasound at 24 weeks, I was told that I had uterine fibroids, although I did not have it. Could uterine fibroids have formed in 2 months?

Most likely, the uterine fibroids were, but small in size. During pregnancy, fibroid nodes rapidly increase in size.