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Could it be twins? Triplets? How soon will you know?

by Dianna Graveman | June 10, 2011 12:00 AM

Several years ago, moms-to-be and their doctors may have suspected twins or a multiple birth, but confirmation didn't always occur until labor began or even sometimes until during delivery.

Today, most women know well in advance of delivery whether they are carrying one, two, or more babies. Ultrasounds, which will usually detect twins or more, are often standard procedure during the first trimester.

Some health care providers, however, may recommend an ultrasound early in the pregnancy only if you are bigger than expected for your due date. Sometimes a date of conception and due date can be miscalculated, and the ultrasound will solve the mystery of whether you are carrying more than one baby or whether you and your doctor must simply adjust your expected date of delivery. If you've received fertility treatments or have undergone in vitro fertilization, the chances of a multiple birth are higher, and your doctor will almost certainly suggest an ultrasound within the first few months. Although cases have been reported in which a twin was "missed" on the ultrasound, the test is typically pretty accurate after about eight weeks. In the case of several fetuses, the ultrasound can be less accurate in determining exactly how many babies you're carrying.

While the ultrasound exam is the most accurate method of determining how many babies you have, other clues may appear to suggest an extra bundle of joy is on the way. But while a common belief is that mothers who are pregnant with more than one baby will gain quite a bit more weight, in reality, mothers of twins usually gain only about ten additional pounds. So weight gain by itself is not usually a red flag that suggests twins are on the way.

ther tests during the first trimester may also offer a clue, but most don't offer solid proof . Your HcG (human chorionic gonadotropin) level shows up in a urine sample by about ten days after you conceive and begins to increase quickly. If you are carrying twins, that HcG level may be elevated, or it may simply be the high end of the normal range for a mother with one baby.

Sometimes, a second or third heartbeat can be detected during the latter part of the first trimester using a Doppler. But again, what sounds like a second heart beat may not always be proof: the "second heart sound" could be the mother's own heartbeat or even just background noise.

Don't count on "morning sickness" for proof: about half of all pregnant women have some kind of nausea or morning sickness during the first trimester. A common fallacy is that mothers carrying more than one baby have twice the trouble or more -- but double the number of babies does not necessarily equal double the nausea. Some mothers of multiples have more morning sickness than others -- and some have none at all.

One clue that is associated with multiples is extreme exhaustion. After all, your body is working extra hard to nourish and nurture more than one child. Other factors can cause fatigue, of course, like work environment or having to care for older children. But if you're more tired than your doctor thinks you should be, he or she may suspect twins.

If you have a family history of twins and suspect you may be carrying more than one child, discuss your concerns with your health care provider. A mother's intuition is often correct, so if you have a family history and a "very strong feeling," be open about your suspicions. Your health care provider will offer guidance as to how soon you should have an ultrasound to see if you're right.

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