A few decades ago, most women with twins didn`t found out that they had a multiple pregnancy until the moment of labor. But now, due to modern technology, such long-term surprises are no longer an issue. In fact, most women find out they are pregnant with twins in the moment of one of the routine examination during the first trimester of pregnancy.

In fact, your doctor will send you to the ultrasound if in the first trimester you gain more weight than you should have for this stage of pregnancy. However, this doesn`t automatically mean you are going to have twins; it`s just as possible for your doctor to have miscalculated your conception date. For this reason, the ultrasound will be relevant to outline whether you`ll have one or more children.
If you remain pregnant due to a fertilization treatment with hCG or IVF, then you`ll need to perform an ultrasound even from the first 8 pregnancy weeks to count how many embryos have been implanted. Generally speaking, the ultrasound is 99% precise regarding the discovery of multiple pregnancies, especially after 6 to 8 weeks of pregnancy from conception.
Table of Contents
Could I Be Pregnant with Twins?
Women who experience a twin pregnancy can have the same symptoms as women who are pregnant with one single fetus, but these signs can appear earlier and can become more pronounced.
A twin pregnancy can produce:
- Excessive morning sickness and vomiting during the first trimester;
- Weight gain;
- Back pain;
- Larger sizes of the uterus than normally for the gestational age;
- More fetal movements than expected during the second and third trimester.
These signs will appear later in during the evolution of the pregnancy:
- Varicose veins;
- Constipation;
- Hemorrhoids;
- Back pain;
- Shortness of breath caused by the augmentation of pressure in the lungs due to the compression exerted by the pregnant uterus against the diaphragm – the muscle that separates the chest cavity from the abdominal one;
- The increase of the abdominal girth;
- Preeclampsia – severe deficiency of the blood flow and blood pressure which affects both the mother and fetus;
- Premature birth.
Ultrasound Confirmation
There`s that old saying: “to see is to believe.” It`s the same when you feel suspicious of a twin pregnancy, where you can use ultrasounds to see your little ones in your belly.
In fact, no matter the symptoms, ultrasounds are these days the best method of confirming the existence of a twin pregnancy.
Using a Doppler Device to Count the Heart Beats
You probably have heard about the Doppler device that uses inoffensive radio waves that amplifies them with the purpose of identifying and counting the heart beats of a fetus. This device becomes very useful in the last part of the first trimester of pregnancy when a skilled doctor may use the Doppler device to identify if we are talking about one or several fetuses. Still, sometimes the identified sounds might be misleading, and what would seem to be a second heart beat is very possible to be just an echo of the heart beats of the same fetus or may just be the sounds of the mother`s heart beats.
Increased Levels of hCG
From various reasons, the doctor who supervises your pregnancy may choose to monitor the hCG level. This is a hormone identified in the urine of pregnant women starting 10 days after conception and which level increases very fast reaching a peak in the week 10 of pregnancy. In these conditions, the twins may lead to the production of a higher level of hCG. However, this method still isn`t 100% sure because the level of hCG that occurs in the case of twins is sometimes in the same limits present in multiple pregnancies.
Abnormal Results in the AFP Test
The AFP test is performed to women in the second trimester of pregnancy. Also known as the maternal serum test or triple marker screen test, this test is used to identify the increased risks in the cases of occurrence of certain congenital abnormalities. Therefore, a multiple pregnancy may produce a positive result or simply a result that is unusually high.
The Belly`s Size
Throughout pregnancy, the doctor or midwife will measure the circumference of your belly as well as the length of the distance between your pubic bone and uterus, both being used as methods of indicating the gestational age. A twin or multiple pregnancy will cause an expansion of the uterus well over the normal sizes for a pregnancy with a single fetus. Still, there are also other factors that can influence the size of a belly, so this measurement isn`t a safe way of identifying a multiple pregnancy either.
Weight
Just as a multiple pregnancy will increase the size of your belly, it will also cause an increased weight, unusually for a pregnancy with a single fetus. In fact, the weight that a woman gains during pregnancy may vary a lot depending on weight, height, body type as well as other factors specific for each and every person. On the other hand, a fast weight gain may reflect more gastronomic exaggerations than a multiple pregnancy. This in the conditions in which a woman who is pregnant with twins doesn`t gain more weight than 5 to 6 kg than a woman with a normal pregnancy.
Excessive Morning Sickness
About 50% of pregnant women experience morning sickness and vomiting associated with pregnancy. Mothers with multiple pregnancies don`t get away of these unpleasant side effects, but they also don`t get a double dose of symptoms of nausea either. In fact, only 15% of the women who took part in a study have claimed that a multiple pregnancy made them feel much sicker than the normal pregnancy they previously had. On the other hand, there are also women who despite they are expecting twins, they don`t feel any signs of morning sickness or nausea. – Similar info!
Fetal Movements Occurred Too Early
To feel your baby/babies moving inside your belly is one of the most beautiful moments during a pregnancy. Regarding this, lots of women who expect twins have claimed they felt their babies moving a lot sooner than it would be normal in a simple pregnancy.
Despite this fact, there`s a certain contraindication in the medical world regarding this subject and no official theory was yet released.
Excessive Fatigue
Fatigue is the most common sign of encountered in women who expect more than a single baby in a pregnancy. Drowsiness, lethargy and exhaustion throughout the first trimester can be much more accentuated because the body works overtime to feed more than one single baby. In both cases, fatigue can also be attributed to other factors (works, family, stress or poor diet), but it may show a multiple pregnancy as well.
History/Suspicions
While all the other signs outlined by now refer to visible signs, excessive symptoms or abnormal test results, maternal intuition shouldn`t be disregarded. At the same time, a history of multiple pregnancies in the family or a strong suspicion may prove to be strong evidence. In these situations, a visit to the doctor`s office is the best solution.
How Do Twins Manage to Be Identical?
Twins that aren`t identical develop in 2 eggs released and fertilized at the same time. They are known as dizygotic twins. On other hand, identical twins come from the same egg and are known as monozygotic twins.
Still, even at identical twins, similarities stop at some point because no human being is identical to another. Therefore, due to various factors, monozygotic twins come to have small differences (often unnoticeable), but enough for their parents to notice.
When Can I Find Out What Kind of Twins I Have?
At least in theory, tests such as amniocentesis or CVS can find out for you what type of twins you expect. However, they are difficult to perform and even dangerous sometimes, especially when talking about multiple pregnancies.
On the other hand, if you cannot or don`t want to perform such tests, an ultrasound can often clear out the mystery. In fact, it will show if your little ones split the same placenta or not, but also if the 2 children are of the same sex or not. From this particular point of view, an experienced doctor who is able to perform a transvaginal ultrasound will be able to tell you precisely if your 2 children split the same placenta. However, keep in mind that this investigation loses from precision along with the development of pregnancy, because once the babies grow, the uterus becomes more and more crowded.
Now, If you have one single placenta, this means you expect monozygotic twins. However, if you also have a second placenta, your little ones can be either dizygotic or monozygotic, in the conditions in which all dizygotic and 20% to 30% of monozygotic twins have separated placentas.
Between weeks 18 and 20 of pregnancy, your doctor can identify the gender of your children, obviously, if both your babies are in such a position to allow a good visualization of their genital areas. If the ultrasound will outline the fact that you`ll have a boy and a girl, then you`ll certainly know that you have dizygotic twins, because 99,9% of cases, monozygotic twins have the same sex.
Why It`s Important to Know What Type of Twins I Have?
Finding out this information isn`t only a matter of general knowledge. It may also be important from a medical point of view.
First of all, monozygotic twins that split the same placenta are exposed to a certain risk during pregnancy. Therefore, around 15% of multiple pregnancies involving monozygotic twins suffer of twin-to-twin transfusion syndrome (TTTS), a very serious medical condition in which one of the twins “donates” fluids to the other one. Therefore, the “receiving” twin tends to grow faster than the donor.
Without treatment, this condition is usually fatal for both babies. From this point of view, it`s essential for the doctor to know what type of twins they are and monitor their development carefully. If there are suspicions regarding the occurrence of TTTS, the doctor needs to intervene right away and prescribe a specific treatment.
To know what type of twins you have is also useful after birth, because if you expect monozygotic twins, and one of the babies is diagnosed with a genetic disease, then the other one will most certainly have it as well. While if you`ll give birth to dizygotic twins, the chances for both babies to suffer of the same condition are much smaller, if not even non-existent.
Last but not least, you`ll discover that people are fascinated by twins, so from friends to relatives or strangers, prepare yourself to answer lots of questions regarding your pregnancy and your future twins.
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