I was also going to ask earlier (but my battery was about tondie so I just hit post) what , if any, is the actual medical benefit of confirming a multiple pregnancy and determining a multiple pregnancy prior to 20 weeks ? In my opinion, I feel like it would only cause unnecessary stress because as far as I am aware simply knowing at that gestation won't improve outcomes at all.
Not opinion, just sneaking back to impart some fact here....you are 1000% wrong about the additional monitoring not improving both fetal and maternal outcomes. Ask any leading authority on multiples, and they'll confirm. I'll be happy to provide links to reputable sources if you're still curious.
Benefits:
- *Prescription* dose folic acid is **needed** to offer developing fetuses the same reduced risk of birth defects as a singleton on regular dose. By 20 weeks any damage to brains and spinal cords is long since done and irreversible. Average amount in a regular prenatal vitamin is 400mcg, average prescribed to a woman having multiples is 2-4mg, or more (conversion is 1000mcg/1mg).
- Additional blood work is needed to rule out other vitamin deficiencies such as the Vitamin D deficiency I mentioned I had. Had I gone all the way to 20 weeks without prescription supplementation to correct my severe deficiency, there is a very real chance both of my boys would have been born with serious and permanent bone/joint deformities - not to mention continued to deplete my own resources and put me at further risk of things like PPD, osteoporosis etc. Vitamin D deficiency is very common, especially for Canadians. The further north you live, the higher the risk (in Alaska for example stats are that as much as 90% of the population is affected). If OP lives somewhere where alternate care is 17 hours away I'd venture to guess she lives way, waaaaaaay up there.
- That same additional blood work (and/or urinalysis) can also detect glucose intolerance and gestational diabetes early on, which is important because the risk of developing it with a multiple pregnancy skyrockets compared to pregnancy with a singleton. Left untreated/undiagnosed often causes preventable miscarriage/stillbirth.
- Same goes for anemia - skyrocketed risk that can definitely cause preventable miscarriage/stillbirth as well as serious maternal risk.
- And preeclampsia.
- Additional early ultrasounds to clarify if multiples are mo/mo, mo/di or di/di save lives. There are babies who were diagnosed before 20 weeks with TTTS who were able to undergo laser therapy that saved their lives. TTTS has a near 100% mortality rate if left untreated.
- Depending on maternal history (and often times just depending on results from the additional monitoring) - progesterone therapy may be necessary in the form of suppositories from day 1 of confirmation or in the form of injections of hydroxyprogesterone starting at 16 weeks. Since risk of preterm labor skyrockets in women pregnant with twins with or without a history of it, it's so important for many to have that additional therapy on board.
Almost to all of the above is completely undetectable by the mother. And not knowing doesn't negate risk.
There are plenty more, but those are the biggie's.
(ETA - I'm not judging your choices mamabean, but I do disagree that just because you had other singleton pregnancies with no problems that you'll be fine either way. Singleton pregnancies are night and day compared to multiple pregnancies. You can neither predict similarities, or avoid complications singlehandedly with good intentions alone. I completely respect that you need to do what you feel comfortable with, but if most mothers of multiples took your approach, fact is, their little ones wouldn't be here today. That doesn't mean if that's what's going on here that yours won't or wouldn't be fine - they certainly could be even with zero monitoring throughout - just speaking in terms of odds because the stats are what they are. All that aside and I can't stress it enough, I wish you and yours well no matter how this turns out for you.)