Signs & Symptoms of a Multiple Pregnancy

Image of a man holding some twins Many women suspect they may be carrying more than one baby, but how can you know for sure?

Symptoms of a Multiple Pregnancy

The following are signs and symptoms of a multiple pregnancy:

Ultrasound Confirmation

Ultrasound is the only way to know for sure if you are carrying multiples.

Doppler Heartbeat Count

Fetal heart sounds may be detected by a Doppler late in the first trimester. Experienced doctors and midwives may be able to detect multiple heartbeats; however, this can be inaccurate because a single heartbeat can be detected in several areas of the mother’s abdomen.

Elevated hCG Levels

Women who are carrying multiples may have increased levels of hCG, which is the hormone that is produced during pregnancy. However, increased levels of hCG does not automatically indicate multiples. Further investigation would be needed to verify the cause of a high hCG level.

Abnormal AFP Test Results

An alpha fetoprotein (AFP) screening, also known as a maternal serum screening or the triple marker test, is performed during the second trimester. This screening is used to detect certain birth defects and measure the amount of a certain protein that is secreted by the fetal liver.

A positive or high test reading may indicate a multiple pregnancy.

Measuring Large for Gestational Age

Most doctors and midwives monitor a women’s fundal height (the distance between the top of the pubic bone to the top of the uterus) during pregnancy. This measurement can help indicate the gestational age.

Women who are carrying multiples often experience increased uterine stretching, and the fundal height may be greater than the actual gestational age. While this may be indicative of a multiple pregnancy, other factors can cause this as well.

Weight Gain

There are numerous factors that can cause excessive weight gain, most of which are attributed to poor eating habits. The amount of weight a woman should gain depends on her height, body type, and pre-pregnancy weight.

On average, women who are carrying multiples only gain about 10 more pounds than those carrying a single baby.

Excessive Morning Sickness

About half of all pregnant women experience some form of morning sickness during pregnancy. While some mothers of multiples report an increase in the severity of morning sickness, many do not.

Just because a woman is pregnant with multiples does not mean that she will experience a double or triple dose of morning sickness.

Early or Frequent Fetal Movement

Although controversial within the medical community, some women carrying multiples report feeling fetal movement earlier than expected. This being said, it is important to note that most women experience earlier movement in subsequent pregnancies.

Extreme Fatigue

While this can also be caused by stress, work, and responsibilities, it is also commonly reported by women who are pregnant with multiples. This may be associated with the mother’s body attempting to provide nutrients to more than one baby.

History or Intuition

A multiples pregnancy can run in certain families. Also, some mothers may have an intuitive feeling that they are pregnant with multiples. Remember that many of these signs can have other causes, and the only way to be 100% positive that you are carrying multiples is through ultrasound confirmation.

Last Updated: 07/2015