In some cases, the onset of preterm labor cannot be halted, while in other situations, risks to the mother or babies require an early conclusion to the pregnancy. Here are some of the most common reasons why twins are born early. But regardless of the reason, when the uterus begins to contract and/or the cervix begins to open in preparation for birth, the result is preterm labor. In some cases, it can be suspended, but when it can not, the babies will be delivered prematurely and born early. Unchecked, it can cause serious medical issues for the mother, including seizures, stroke, and liver damage. Preeclampsia can be managed, but there is no cure except to deliver the babies. When preeclampsia causes sufficient maternal distress, early delivery of twins may be recommended. With the placenta(s) in multiple pregnancies covering a greater proportion of the uterine wall, there is a higher risk of complications that can be dangerous for mom or babies. Placental abruption or placenta previa are some situations that might prompt an early delivery. While placental problems like these can also impact singletons, Twin-to-Twin Transfusion Syndrome (TTTS) is a disease unique to twins. It occurs when abnormal blood vessels develop in a single, shared placenta, resulting in an unequal exchange of blood flow. In severe cases that compromise the babies, delivery may be an option. But sometimes the sac ruptures before a woman goes into labor. When this happens, it is called premature rupture of membranes (PROM). If the water breaks prior to 37 weeks gestation it is referred to as preterm prelabour rupture of membranes (PPROM). Once the bag of waters breaks, it presents an opportunity for infection if delivery isn’t imminent, and may prompt an early delivery of twins. There is a danger of cord entanglement or cord compression in this situation, a serious situation that compromises the babies’ survival. In some cases where this occurs, the best option for babies is premature delivery. While twins tend to be smaller than single babies, up to one-quarter of twin pregnancies experience IUGR. There are multifactorial causes for this growth restriction, such as placental insufficiency, low amniotic fluid, or twin-to-twin transfusion syndrome (TTTS). If it is determined that a twin has completely stopped growing or is in distress, early delivery may be the best option. For some, elective birth at 37 or 38 weeks is ideal for an otherwise uncomplicated twin pregnancy, so your doctor may schedule a delivery a couple of weeks early. Others prefer to wait and see.
