Sign of a twin pregnancy?

Some women who have twins report symptoms and suspicions right from the start but just as many others are shocked to see two little heartbeats at the ultrasound.
So what signs can you look out for?

Increased and/or earlier morning sickness

Increased morning sickness or morning sickness that appears very early on in pregnancy can be a sign that you are carrying more than one baby. However, it is not one of the most reliable ways!...many women have severe nausea single pregnancies and it can occur very early on.

Increased uterus size.

If you are told by your doctor or your midwife that you are measuring “big for dates” you could be carrying twins. It is also possible that your pregnancy dates have been miscalculated and you are further along than originally thought. Either way you will probably be sent for an ultrasound to find out.

Showing early

Twin pregnancies often become noticeable slightly earlier than non twin pregnancies, you may for example, notice a bump at 10-11 weeks rather than 12-14. However, by the time this occurs you will often have had a twin pregnancy confirmed through ultrasound. Don't worry if you know you are expecting twins and are not seeing any signs of a bump at 12 weeks, every women and every pregnancy is different and there are huge variations in what is considered “normal”.

If you feel that you are “showing” earlier than in previous pregnancies, it is worth remembering that second pregnancies almost always begin to show earlier than first pregnancies and so this may not actually be a sign of a twin pregnancy. Bloating is also common in early pregnancy and can cause you to look pregnant very early on both with single and twin pregnancies.

 

Ultrasound

The only positive proof of a twin pregnancy is seeing the two babies on an ultrasound. Most areas give an ultrasound at between 6 and 12 weeks in order to confirm a healthy pregnancy and most twin pregnancies should be visible by this point.

High levels of HCG

High levels of the pregnancy hormone HCG can signal more than one baby, it can also be a sign if the levels of hormone double much more quickly than normal. It is worth remembering that levels of HCG vary greatly from woman to woman. For example at 21 days since ovulation hormone levels vary between 324- 4139 mIU/ml . Anything within this range is normal for a single pregnancy. If you have a higher range than this or if you fall very high up within this range your doctor or midwife may suspect twins and send you for an ultrasound to confirm his or her suspicions. Normal range for a singleton pregnancyis as follows:

Weeks from the Last Menstrual Period	Amount of hCG in mIU/ml
3	5 - 50
4	3 - 426
5	19 - 7,340
6	1,080 - 56,500
7-8	7,650 - 229,000
9-12	25,700 - 288,000
13-16	13,300 - 254,000
17-24	4,060 - 165,400
25-40	3,640 - 117,000

Hearing two heartbeats

If your hear two heartbeats on a Doppler it is possible that it is two separate babies. However, it is very easy to mistake a single heartbeat for two separate ones. There are a number of reasons for this. Firstly you could be hearing the same heartbeat echoing around your uterus. Secondly you could be picking up on the blood flow around the uterus itself, for example through the placenta or umbilical cord. It is possible that hearing two heartbeats means two babies, however it is unusual that twins are picked up in this way.