Q: How is a multiple pregnancy diagnosed?

A: Higher than expected blood pregnancy test levels (HCG) early in pregnancy can suggest a multiple gestation, but the only way to confidently diagnose multiple gestations is with an ultrasound exam. Transvaginal sonography, as early as 6 weeks gestation, is used to diagnose multiple gestations. Sometimes, as a pregnancy progresses, fetuses may be missed in higher-order multiples. Some quadruplet or quintuplet fetuses remain undiagnosed and are first found at the time of delivery because ultrasound exams create optical illusions making imaging more difficult.

Answer courtesy of Victor Klein, MD Perinatologist, Great Neck OB/GYN.

Symptoms of multiple pregnancy may include:

  • uterus is larger than expected for the dates in pregnancy
  • increased morning sickness
  • increased appetite
  • excessive weight gain, especially in early pregnancy
  • fetal movements felt in different parts of abdomen at same time

Tests used to diagnose a multiple pregnancy include:

  • HCG blood tests
  • Alpha-fetoprotein test
  • Ultrasound

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