Two little hearts on the ultrasound image: The news of a twin pregnancy can bring great joy and raise many questions. At the USZ, specialists support expectant parents from the first examinations through to the birth, including prenatal treatment options and the option of a spontaneous delivery.
Not all twins are the same
Identical or fraternal? This is a question that many expectant parents ask themselves after learning they are expecting twins. For medical care, however, something else is most important: Do the two babies share a placenta and an amniotic sac?
In DiDi twins, each child has its own placenta and amniotic sac. MoDi twins share a placenta but develop in separate amniotic sacs. MoMo twins are particularly rare; there are estimated to be only about four such pregnancies per year in Switzerland. They share both the placenta and the amniotic sac.
This difference is not a minor detail; rather, it shapes the entire course of care. This is because, in twins who share a placenta, vascular connections between the babies can cause complications that require close monitoring. An ultrasound can determine early on whether the babies share a placenta or an amniotic sac.
“If there is only one placenta and complications are detected early, we can also offer targeted treatment in certain situations, such as in cases of feto-fetal transfusion syndrome (FFTS).”
When Twins Need Special Medical Care
Most twin pregnancies proceed without serious complications. However, certain risks are increased, such as preterm birth, differences in the babies’ growth, or pregnancy-induced hypertension.
Feto-fetal transfusion syndrome (FFTS) poses a particular challenge. It can occur when twins share a placenta and blood is distributed unevenly between them via vascular connections: one receives too little, while the other receives too much. Both children are affected, each in their own way.
The USZ offers a treatment for this complication that begins even before birth: Using a highly specialized laser procedure performed in utero, the connecting blood vessels on the shared placenta are selectively sealed. The goal is to functionally separate the blood circulations of the two children from one another. The USZ is one of the few hospitals in Switzerland that performs this procedure.
Giving Birth to Twins Spontaneously
Do twins have to be delivered by C-section? Not necessarily. At the USZ, a spontaneous delivery is also possible under the right conditions. The first requirement is the mother’s wish. When planning the delivery, the position and growth of the babies as well as the course of the pregnancy are also taken into account: If the first baby is in a head-down position, the babies are roughly the same size, and there are no significant complications, a vaginal delivery may be an option.
During labor, both babies are carefully monitored. An experienced team of obstetricians and midwives supports the mother. The expectant mother’s wishes and the medical requirements are discussed together. The neonatology department is informed of every twin birth and is on call. In an emergency, an unplanned cesarean section can be performed within minutes.
Well-supported from the first ultrasound through to the birth
From the moment you first see those two little hearts until the birth, new questions may arise time and again. At the USZ, our specialists work with expectant parents to determine what kind of care and birth plan best suits their situation. The focus is on the health of the mother and children, as well as the needs of the expectant parents.
