Prenatal Care of Twins: Early Care and General Advice

By on December 12, 2023

Congratulations, you’re having twins! How cool is it that you get to bring not just one new life into the world, but two? Pregnancy, whether you are expecting multiples or a singleton, can seem like a daunting experience, especially when you think about all the doctor’s appointments, lifestyle changes, and supplies that you need to collect. Multiplied by two, it may even seem near impossible. At Carnegie Imaging for Women, we are here to help you through your pregnancy and beyond to make it, not only a stress-free experience but an enjoyable one. The best way we know how to do this is by educating our patients on what to expect during their pregnancies and how receiving care specific to your pregnancy situation can make a world of difference. For those having twins, this means paying close attention to care during the early stages of pregnancy.

Early Care of Diamniotic Dichorionic Twins

Not all twin pregnancies are alike, just like not all singleton pregnancies are alike. Depending on the type of twins you are having, different tests, scans, and advice will be more effective than others. For this article, we will focus on diamniotic dichorionic twins. These are twins that are likely not identical (though sometimes they can be) and have two different placentas. In other words, each fetus has their own amniotic sac and their own placenta. Early care of such twins can be broken down into three different categories: tests and screenings, nutrition, and lifestyle. While it is not required, we do recommend that women who are pregnant with twins have a consultation with a maternal fetal specialist.

Early Tests and Screenings for Twins

One of the first scans where twins will be detected is at around 6-8 weeks. It is at this time that your doctor will be able to detect two fetal heartbeats. It is at this scan that your doctor will also be able to identify a vanishing twin when there are two fetuses but only one heartbeat. This is not uncommon in early pregnancy. It is around 11 to 13.5 weeks that you will have blood tests done for genetic abnormalities such as aneuploidy, down syndrome screening, nuchal translucency test, and structural evaluations. These are all performed to detect the proper development of the fetuses as well as if they are at high risk for any genetic conditions.

For diamniotic dichorionic twins in particular, a combination of NIPT, non-invasive prenatal screening, such as cell-free DNA collected from a biochemical screening to look at the hormone levels of the placenta, and a nasal bone test, which detects the absence of a nasal bone, is 99% accurate in detecting down syndrome. There is only one particular NIPT test on the market called Panorama that can determine if the twins are identical (monozygotic) or fraternal (dizygotic), this is the NIPT testing that is preferred in our practice.


When it comes to your office visits, you won’t always be talking about tests, results, and medical lingo. In fact, a good chunk of time will be spent going over the proper nutrition for yourself and your twins during pregnancy. In most cases, women can expect to gain 40-50 pounds during a twin pregnancy. This is attributed to the fact that you are carrying two babies, two amniotic sacs, and two placentas, not to mention the increased breast mass, increased blood volume, and increased water retention. Only a small proportion of this weight gain is due to fat. Because your body is going through such a big physical change, nutrition is very important, which is why everyone should have a nutrition consult. During this appointment, your doctor will go over a breakdown of the amount of fats, carbohydrates, and protein in a regular meal and how that applies to your eating habits and culture. A good, proper nutrition consult will go over the appropriate weight gain and the appropriate caloric intake for pregnancy with twins. Data has also shown that proper nutrition and weight gain, particularly in the early weeks of pregnancy, can have an impact on decreasing preterm birth in twins.

Lifestyle Changes

Your lifestyle is going to change when you become pregnant, but you might be surprised at how close to normal you can go about your daily life whilst pregnant with twins, assuming you do not have a high-risk pregnancy. While you might need to take a little more time off from work with twins than with a singleton, there are really no restrictions when it comes to your job. This, of course, applies if you do not have a physically intense job. Assuming you do not have a short cervix, vaginal bleeding, or placenta previa, there are no restrictions regarding sexual intercourse either. Traditionally it was advised that you stop exercising at 20 weeks, but, while few studies have been performed on twins, exercise during pregnancy is actually encouraged. Cardiovascular exercise, yoga, and swimming are all safe ways to continue moving throughout your pregnancy. In fact, remaining active during pregnancy, in a safe way, can build stronger bones and muscles and may make laboring easier.

Schedule a Consultation

If you are pregnant, or thinking about becoming pregnant, schedule a consultation at Carnegie Imaging for Women to learn about how we are committed to providing the best care to mothers in Manhattan’s Upper East Side and surrounding areas before, during, and after their pregnancy journeys. Head to our website to fill out an online contact form and get started today.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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