Multifetal Pregnancy Center

Genetic abnormalities in pregnancy happen when there’s a problem with one or more of a baby’s chromosomes. Chromosomes are the tiny sets of instructions in our cells that make each person unique. At Ochsner’s Multifetal Pregnancy Center, we offer several types of screening and diagnostic tests to check for genetic conditions in pregnancies with more than one baby.

At the Ochsner Multifetal Pregnancy Center, our nationally certified maternal-fetal medicine doctors and sonographers are highly trained in performing these tests. We’re proud to offer families some of the most advanced genetic testing options available in the country.

Prenatal Screening Tests

Prenatal screening tests can estimate a baby’s risk for certain genetic conditions like Down syndrome without any risk to the pregnancy.

During the early part of pregnancy, around 11 to 13 weeks, you can choose first trimester screening, also called nuchal translucency (NT) testing. NT screening in twins can detect more than 85% of Down syndrome cases, making it one of the most effective early screening options. The screening includes:

• An ultrasound to check for extra fluid at the back of the baby’s neck, which can sometimes be a sign of a chromosome abnormality
• A simple blood test

Between 15 and 21 weeks of pregnancy you may choose a quad screen. This is a blood test that can detect possible chromosomal abnormalities.

Diagnostic (Invasive) Tests

Several diagnostic tests can confirm whether a chromosomal abnormality is present. These tests can also diagnose inherited conditions like cystic fibrosis or sickle cell disease. These tests include:

• Chorionic Villus Sampling (CVS): A small sample of the placenta is taken between 11 and 14 weeks.
• Amniocentesis: A small amount of amniotic fluid (the fluid around the baby) is taken after 15 weeks.

Detailed Ultrasound Evaluation

As part of your specialized prenatal care, you’ll also have a high-definition ultrasound around 18 to 20 weeks. This scan checks for physical differences or birth defects, which can be more common in multiple pregnancies. While ultrasounds don’t detect every genetic condition, they sometimes identify issues that other tests may not catch.

One of the most common challenges with carrying multiples, like twins or triplets, is the risk of preterm labor and early delivery.
The average length of pregnancy is:

• 35 weeks for twins
• 32 weeks for triplets
• 29 weeks for quadruplets

While 35 weeks may sound close to full term, twins are about 10 times more likely, and triplets 30 times more likely, to be born very early (before 32 weeks). Babies born this early face a higher risk for long-term health complications.

Recognizing Risks Early

The best way to manage the risk of premature delivery is through early detection. Understanding the risks can help doctors take actions to help delay labor or prepare for an early birth. At the Ochsner Multifetal Pregnancy Center, our maternal-fetal medicine specialists use advanced monitoring to keep a close eye on your pregnancy and give every baby the best chance for a healthy start. We monitor your pregnancy using:

• Transvaginal ultrasound: Measures the length of the cervix (the lower part of the uterus). A shorter cervix can be a sign of preterm labor risk. Our team will conduct cervical length checks with every two weeks from 16 to 28 weeks
• Fetal fibronectin test: Looks for a special protein in vaginal discharge. If this protein is found, it may mean labor could start sooner than expected. Our team will recommend this test for anyone showing signs of preterm labor.

If we find that the cervix is shortening or that fetal fibronectin is present, we can take action to help prevent early delivery. Your doctor may recommend giving steroids to help your baby’s lungs develop faster, using medications to reduce contractions or performing a cerclage, a minor procedure where a stitch is placed around the cervix to help keep it closed.

A baby’s growth during pregnancy depends on many factors, including blood flow to the uterus, how well the placenta provides nutrients, where the umbilical cord connects to the placenta and the baby’s own genetics. As the number of babies in the uterus increases, space and nutrients are shared, which can change how each baby grows.

About 15% to 25% of twin pregnancies and more than 35% of triplet pregnancies show signs that one or more babies are not growing as expected. This is called intrauterine growth restriction (IUGR), or poor fetal growth. Low birth weight can lead to complications and increase the risk of fatality before age one. Because growth restriction is more common in multiple pregnancies and can affect newborn health, early detection and careful monitoring are essential.

At Ochsner’s Multifetal Pregnancy Center, our team includes the area’s largest group of maternal-fetal medicine doctors and nationally certified sonographers, all trained to detect and manage fetal growth concerns. As part of your specialized care, we:

• Check each baby’s growth every four weeks using high-resolution ultrasound and growth charts designed for multiples
• Monitor more often if any growth problems are found
• In severe cases, provide more intensive care, which may include hospital monitoring with daily checks on both you and your babies

Nutrition for Multiple Babies

Healthy nutrition and eating well supports your health and help your babies grow. At Ochsner’s Multifetal Pregnancy Center, our board-certified nutritionists can help you address any dietary issues you may have, while ensuring each of your meals has the right balance of nutrients for your multifetal pregnancy. 

Your nutrition visit will cover:

• Discussing cravings or food aversions you may be experiencing
• Choosing foods to help fight fatigue
• How to make sure you're eating enough foods high in nutrients
• Tips for drinking enough water and staying hydrated
• Discussing supplements, if needed

Together, we build a plan around your favorite foods, schedule and activity level, on top of getting easy tips and a sample meal plan.

Exercise for Multifetal Pregnancies

Exercise during a multifetal pregnancy is safe for most moms and can be good for both you and your babies. Strict bed rest is not always needed and light to moderate exercise often leads to better outcomes and a healthier pregnancy.

Our center works with expert trainers at Ochsner Fitness Center. As part of care at Ochsner, you get access to trainers experienced in pregnancy care. If you need to limit movement, our physical and occupational therapists will show you safe ways to stay active and support your well-being.

Ochsner's Multifetal Pregnancy Center is devoted to creating a warm and compassionate environment for mothers interested in breastfeeding. Research shows that breastfeeding has been associated with improved infant outcomes, especially for those born preterm. Our Lactation Consultants for Breastfeeding services consists of dedicated and experienced certified nurses who provide mothers with education, guidance and the tools for successful breastfeeding.

As part of you care here at Ochsner, pre-delivery consultations are available in the second and third trimester of pregnancy to introduce expectant mothers to the principles of breastfeeding. Patients meet with one of our lactation consultants and are given a personalized assessment which includes dietary recommendations, nursing techniques and commonly asked questions. Mothers are also given supportive assistance in the transition back to work or school while continuing breastfeeding.

Twin to twin transfusion syndrome (TTTS) is a rare but serious problem that can happen in some twin pregnancies. It only occurs in twins who share a placenta, called monochorionic twins, which make up about 1 in 5 twin pregnancies. In 10-15% of these cases, blood from one twin (the donor) flows to the other twin (the recipient). This uneven blood flow can cause serious health issues for both babies. Without treatment, TTTS can lead to the loss of one or both twins in over 80% of cases.

At Ochsner's Multifetal Pregnancy Center in New Orleans, we work to identify the risk of TTTS early. During the first visit, we use ultrasounds to closely examine the twins and their shared placenta. If the twins share a placenta, our specialists perform high-quality ultrasounds every two weeks to check for signs of TTTS. Early diagnosis and treatment, such as reducing amniotic fluid, laser therapy, or early delivery, can improve outcomes for the babies. Our team is committed to providing the best care to ensure healthy pregnancies.