If I may as a question of the mw's...

[BirthFree]

Sorry, I am sure this is a really over-talked about topic so I hope it's not over the top...

At what point do you seriously consider a Mom is pg with twins? Is it based on measurements, movement, feelings?

(I'm measuring 3-4w ahead consistently each week (I'm 14w 4d) and am a fraternal twin... had 24 hour morning sickness this time around that I did not have with my two boys (no one m/s day)... started feeling movement at 11.5w... but don't want to put too much into all this).

Any thoughts for the pondering minds?
Thanks so much...
~Julie

[CarolynnMarilynn]

I would mostly go on measurements and the actual feel of the uterus. Sometimes it measures big but feels the right size. I would expect with twins that the measurements be at least 4-6 weeks above what I would expect before really considering twins. The last set I had the woman's fundus, or top of her uterus, was nearly at her belly button at 12 or 14 weeks, a size I would associate with being around 20 weeks.

Along with that I would try to asculatate two heartbeats with rates at least 10-15 beats per minute apart, be aware of severe nausea, and palpating two little ones (harder to do early like you are).

Just FYI and apart from your question I would recommend an ultrasound early if I suspected twins (though it woudn't be a necessity) because if the babies share a placenta and sac (monochorionic) there are complications that can come with that, and I would suggest more monitoring to detect twin-to-twin transfusion syndrome early. There is such a relief I feel when I know twins are dichorionic (not sharing a placenta and chorion), and most are not monochorionic, and feel that there is a much higher chance of a totally normal pregnancy and birth. It is harder to determine if the twins are monochorionic as time goes on, so an early ultrasound is an advantage, if the woman is open to having one. I understand that this is a fairly medical approach, but TTTS is awful.

[pamamidwife]

you know, it's often the mothers preg with their third that seem to pop out earlier. 3-4 cm ahead isn't that big of a deal to me, but it seems it would be more apparent around 24-28 weeks.

[Apricot]

I'm not usually measuring until 20-24 weeks anyway, just feeling for the top of the uterus and ensuring that it's a little closer to the umbilicus each time.

I think there was a mama here that was pregnant with twins that didn't have a huge fundal jump until 28 weeks, when she measured 33 cm.

[hippiemom]

Just chiming in here...

with #3 I was HUGE, from about 5 months on measured 5-7 weeks ahead of dates. I was certainly big enough to have been carrying twins (or quads! haha) but it turned out I had a big ol baby and a lot of extra amniotic fluid. I would say if you are so curious about it you could talk your concerns over with your caregiver and decide if you need an ultrasound to take a peek, for your own peace of mind and for your caregiver to be better informed... Other mamas of 3 have confirmed as will I that we just pop OUT and get big with that 3rd one:lol