Originally Posted by nancymom
Yikes, I didn't know that! Is that only talking about when twins share a placenta or even if there are 2 placentas? 38 weeks is my goal but my secret goal is to go 40 weeks. Of course I only want what is best for my babies and I want them to come at the optimal time.
Twins mature faster in the womb than singletons do. Triplets mature even faster than twins. Nature indeed knows what she's doing, as multiples generally do not make it til 40 weeks before delivery happens.
At 42 weeks with a singleton, the risk of stillbirth begins to rapidly increase, thus the extreme pressure from most providers to get labor going by 42 weeks, assuming of course that you are working with good dates.
The risk of stillbirth begins this rapid increase at 38-39 weeks with twins. There is absolutely ZERO medical research to support allowing a twin pg to progress past 39 weeks. The risk of stillbirth is a huge concern. Also, the risk of cord compression due to the fact that they are just squished in there by that point is also a major concern.
Post-maturity, while a rare problem with multiples, is something that certainly CAN occur and should be avoided to improve the chances of two healthy babies. Most research indicates the best outcomes for twin pregnancies occur when delivery happens between 37-38 weeks. Not too soon, and not too late. Just right.
Again though, you have to have a CORRECT due date that you're going on, otherwise things are a bit more difficult. Ultrasound can be used to determine if the placenta(s) are calcified (a bad sign). Non-stress tests can be used to determine if both babies are doing well in the womb, and are believed to indicate that things should be 'ok' for at least 72 hours barring an unforseen complication like cord entanglement or abruption. Amniotic fluid levels are harder to measure with twins, although u/s can give you a general idea of what it going on with fluid levels.
I'd say at a minimum, a twin gestation should have a NST and u/s done at about 38 weeks, no later than 39 weeks, if labor does not appear to be imminent just to make sure the uterine environment is still healthy for both babies.
No way on earth would I go 40 weeks with twins, much less over 40 weeks, even if it meant induction and/or c-section. There IS a point that OUTSIDE is safer than INSIDE, no matter HOW they get out.