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Earliest Signs of Twins in Pregnancy

It is important to recognize the earliest signs of twins in pregnancy because of the increased risks associated with twin pregnancies, and the precautions women pregnant with twins are asked to take. While nothing is certain until your physician performs an ultrasound, there are signs you can watch for as soon as you know you're pregnant.

Before Pregnancy

It's useful to know that your chances of having a twin pregnancy increase significantly if you're over 35 at the time of conception, twins run in your mother's family, you used fertility drugs to stimulate ovulation, or you underwent in vitro fertilization.

Showing More, and Sooner

If you've been pregnant before, increased abdominal size and weight gain compared to the same stage in your previous pregnancies could be your first hint of a twin pregnancy. However, if you've only been pregnant once before, the comparison may not be indicative of twins, as the uterus and ligaments never fully return to their pre-pregnancy state after the first pregnancy, so subsequent pregnancies are always likely to show larger and sooner than the first one.

Exacerbated Pregnancy Symptoms

With a twin pregnancy, all the normal injustices of pregnancy, including back pain, morning sickness, water retention, and fatigue, can be magnified.

Early Risers

While the phenomenon hasn't been confirmed by the medical community, and reports remain controversial, many women pregnant with twins have reported feeling fetal movement earlier in their twin pregnancies than during singleton pregnancies.

Multiple Heartbeats

Physicians can sometimes hear multiple fetal heartbeats as early as 10 weeks after conception. It is hard to diagnose a twin pregnancy this way, however, because fetal heartbeats can be heard from different locations. The doctor can only confirm a twin pregnancy if the fetuses' hearts are beating at different rates.

An Abnormal AFP Test

An alpha- fetoprotein, or AFP, test is administered between 16 and 18 weeks into a pregnancy to help screen for high risk pregnancies and birth defects. Fetal livers excrete AFP, levels of which can be measured in the mother's blood, and elevated levels can be one of the first signs of a twin pregnancy.

Confirmation of Twins

If you suspect you are pregnant with twins, your physician can schedule an ultrasound to confirm a twin pregnancy as soon as six weeks after conception.