Think you might be pregnant with twins? Here are some common signs and symptoms that may be associated with a twin pregnancy.

Rapid weight gain

Women pregnant with twins typically gain weight faster than those pregnant with singletons. The greater weight gain in twin pregnancies is not only expected, but healthy for twins. For a normal sized woman, the recommended ideal weight gain for singletons is 25-35 pounds whereas ideal weight gain for twins is 37-54 pounds.

Uterus (fundal height) measures large for gestational age.

Starting at around 20 weeks, the centimeter height of the uterus above the pubic bone is roughly equivalent to the number of weeks of gestation. However, with twins, the uterus can measure several centimeters above what would be normal for a singleton.

Feeling fetal movement early

Some women report feeling early fetal movement with twins.

Abnormally high HCG level (or rapid rise of HCG level)

Blood tests for HCG typically show higher levels than with singletons and the rate of rise is greater. Home pregnancy tests can become positive earlier than normal (in Twins 101, I share about how I had a very positive reading on a home pregnancy test even though it was at least a week before my next period).

Abormal AFP

Typically used as a second trimester screen for birth defects and chromosomal abnormalities, AFP levels may be higher in twin pregnancies. Sometimes, mothers discover they are pregnant with twins because an abnormal AFP level prompts an ultrasound examination.

Two different heart beats detected on Doppler

Sometimes twins may be suspected because there appears to be two different heart beats heard on Doppler. In reality, determining the presence of two heart beats can be difficult unless you use two monitors simultaneously. With two monitors, twins would be suspcted if the heart rate on each monitor is different since two hearts won’t beat consistently at exactly the same rate.

Two babies on ultrasound

This is the easiest and most definitive way to find out prenatally if you’re pregnant with twins. Most doctors will perform an ultrasound if they suspect you are pregnant with twins for any of the reasons above.

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Khanh-Van Le-Bucklin