Signs and symptoms a multiple pregnancy

By April 9, 2020Obstetrics

While many women prepare to have a baby, it is almost always a shock when they discover that they are carrying two! While multiple births such as twins or triplets are rare, (occurring in about 2% of the population), they are still a very real possibility.


So how do you know if you are carrying more than one baby? Take a closer look at the signs and symptoms of multiple pregnancies.


While many women suspect they are pregnant with twins because of a number of symptoms, the most reliable way to tell is through an ultrasound. The best time to have an ultrasound is between ten and twelve weeks of pregnancy. This is usually when a healthcare professional can say for sure how many fetuses, placentas and amniotic sacs there are.


Late in the first trimester, fetal heart sounds may be detected by a Doppler. A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through a person’s blood vessels by bouncing high-frequency sound waves off circling red blood cells. Experienced doctors and midwives might be able to detect multiple heartbeats; however, it is essential to note that this can quite often be inaccurate. This is because a single heartbeat can be detected in several areas of the mother’s abdomen, rather than just one (or two) specific places.

hCG levels

Women who are carrying multiples may record higher levels of hCG. hCG is the hormone produced during pregnancy. It can be seen. However, increased levels of hCG do not always indicate multiple pregnancies. Further investigation may be required in the form of ultrasound or checking other symptoms.

AFP screening

An alpha-fetoprotein screening, (AFP), also known as a maternal serum screening or the triple marker test, is performed during the second trimester. It is used in order to detect certain congenital disabilities and measure the amount of protein that is secreted by the fetal liver. Sometimes, a positive or high test reading may indicate a multiple pregnancy. However, extra investigation will probably be required.

Weight gain

The amount of weight a women gains during pregnancy can vary greatly depending on factors such as height, pre-pregnancy weight and body type. However, it can be seen that multiple pregnancies will naturally mean a woman will gain more weight. On average, a woman will carry ten extra pounds during pregnancy for every baby they are carrying.

Morning Sickness

While morning sickness is a very normal symptom of any pregnancy, excessive vomiting and nausea may signify multiple pregnancy. Only half of all pregnant women report experiencing morning sickness, and only some of those carrying multiple babies will feel excessive morning sickness.

Gestational age

Doctors and midwives will most likely monitor a woman’s fundal height. This is the distance between the top of the pubic bone to the top of the uterus) during pregnancy. This measurement might help indicate the gestational age, which is a measure of the age of a pregnancy, taken from the beginning of the woman’s last menstrual period. Women who are carrying multiple babies will sometimes experience uterine stretching, and the fundal height may be more than the gestational age. While this may indicate a multiple pregnancy, other factors might cause this as well, so extra investigation should be undergone. 

If you have any questions regarding multiple pregnancies or would like to book an appointment, please do not hesitate to get in touch with Dr Bevan Brown. As one of the most trusted obstetricians in Sydney and will be thrilled to give you complete and compassionate care in every way possible.