Twin Pregnancy Symptoms / Multiple Pregnancy Symptoms – Diagnosis


  • History collection
  • History of ovulation inducing drugs specially gonadotrophins, for infertility.
  • Family history of twining (more often present in the maternal side)
  • Symptoms
  • Increased nausea & vomiting
  • Cardio pulmonary embarrassment.
  • Tendency of swelling of legs,    varicose veins and hemorrhoids.
  • Unusual rate of abdominal enlargement and excessive fetal movements.
  • General Examination
  • Prevalence of anemia is more than in singleton pregnancy.
  • Unusual weight gain, not explained by pre-eclampsia or obesity, is an important feature.
  • Evidence of pre-eclampsia. (25%) is a common association.
  • Abdominal Examination
  • Inspection :
  • the elongated shape of a normal pregnant uterus is changed to a more ‘barrel shape’ and the abdomen is unduly enlarged.
  • Palpation :
  • The height of the uterus is more than the period of amenorrhea.
  • The girth of the abdomen is more than the normal average at term (100cm).
  • Fetal bulk seems disproportionately larger in relation to the size of the fetal head.
  • Palpation of too many fetal parts.
  • Finding of two fetal heads or three fetal poles make the clinical diagnose almost certain. 
  • Auscultation:
  • Simultaneous hearing of Two distinct fetal heart sounds located at separate spots with a silent area in between by two observers, gives a certain clue in the diagnosis of twins, provided the difference in heart rates is at least 10 beats per minute.
  • Internal Examination:
  •    In some cases, one head is felt   deep in the pelvis, while the other one is located by abdominal examination. On occasions, the clinical methods fail to detect twins prior to the delivery of the first baby.

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