Twin pregnancy: symptoms and preparation

Written by: Mr Keith Duncan
Edited by: Robert Smith

About 1 in every 65 births in the UK today are twins, triplets or more. With it comes more responsibility than when it’s just a single baby.


We’ve spoken with top consultant obstetrician and director of The Chelsea Birth Clinic, Mr Keith Duncan, for guidance on how to manage a multiple birth.

What causes twins in pregnancy?

Conception happens when a sperm fertilises an egg where as some women produce more than one egg during a cycle and if there are two eggs then that gives you two separate embryos. In the case of identical, the eggs splits into two which is the monozygotic stage. There are two type of twins, non-identical and identical.

What are symptoms of twin pregnancy?

The symptoms of a twins often are very similar to being pregnant with one baby but women can often experience more morning sickness.

When does a twin pregnancy start to show?

If you have triple, or quad it could possibly show by 12 weeks. Whereas someone with a single baby, 3 or 4 months. A twin pregnancy can show sooner, within 6 to 8 weeks as there is more bloating. You notice it earlier, even before 3 to 4 weeks earlier than a normal pregnancy with one baby.


Can twin pregnancy be missed at ultrasound?

It would be very unusual to miss a twin pregnancy. There are quite distinguishing features, you may be able to see more than one placenta during an ultrasound. Usually pregnancy of twins is monochorionic as opposed to diacroionic pregnancies. Monochorionic pregnancies which experience two individual placentas that use together, have more complications.


What makes a twin pregnancy riskier than single pregnancy?

They often say, double trouble, but most of the complications of pregnancy are much more common in multiple pregnancy. It’s worse if the babies share a placenta or a sack. It’s specific to monochorionic twins. The most common problems are early labour and birth. Sometimes the twins are born prematurely.

We advise mums with twins to rest as they’re more prone to getting high blood pressure, diabetes, risk of anaemia. Birth defects such as cleft lips are more common. Bowel problems and heat, a miscarriage is much more common if the babies have a shared placenta or there’s a twin sack. They need much higher levels of monitoring. Twin pregnancies are much more likely to be delivered with a caesarean section and for the safety of the babies.

Is there any additional monitoring that may be required for a woman pregnant with twins?

If your babies share a placenta, you will be offered growth scans more often than if they each have their own placenta, every two weeks from 16 weeks onwards. This will require more frequent visits to the hospital.

If you’re looking for a top obstetrician and gynaecologist to monitor your pregnancy, we recommend booking an appointment with Mr Keith Duncan via his Top Doctors profile.

By Mr Keith Duncan
Obstetrics & gynaecology

Mr Keith Duncan is a highly expert and leading consultant obstetrician and director of The Chelsea Birth Clinic, London. With over 30 years' experience, Mr Duncan has delivered more than 3,000 babies both in the NHS and as one of Europe’s top private obstetricians. Mr Duncan’s expertise are in the area of caesarean, childbirth, antenatal care, multiple pregnancies, ultrasound, and high-risk pregnancies.  

Mr Duncan graduated in 1989 with a bachelor of medicine and chemistry (MB ChB) from Leeds University, and went on to undertake training in the North of England before relocating to London for his specialist training in maternal and foetal Medicine. Since 2003, he has held his NHS role as consultant in Chelsea and Westminster Hospital. In 2001, he was awarded accreditation as a sub-specialist in maternal and foetal medicine. 

Together with his personable and calm approach have gained him the reputation as a brilliant practitioner in multiple and high-risk birth situations. He is renowned for his hands-on approach, down-to-earth manner and meticulous attention to detail, making him a popular choice with both first-time mothers and a loyal following of repeat patients. He is a strong supporter of personal choice in childbirth and listening to the individual needs and wishes of each patient. Whether it’s water births, caesareans or hypno-birthing, his philosophy is to provide a positive birth experience for all parents to be. 

As a member of the British Maternal Foetal Medicine Society, he served as the representative for London and the southwest at the prestigious Royal College of Obstetricians and Gynaecologists, taking an active interest in global women’s health, ultrasound scanning, and development in utero.  

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