After Ronaldo loses newborn, UAE doctors weigh in on twin pregnancy risks

Image Courtesy: Khaleej Times

On Monday, Cristiano Ronaldo revealed to the world the devastating news that he and his partner Georgina Rodríguez, who was pregnant with twins, had lost one of their newborns, a boy.

The couple described the grief as the “greatest pain”, adding: ‘Only the birth of our baby girl gives us the strength to live this moment with some hope and happiness.”

While the reasons why the baby failed to survive have not been revealed, but given the fact that it was a twin pregnancy, the risk factors were higher and there could have been a number of reasons behind the tragedy.

Twin pregnancy, or a higher order multiple gestation brings its own set of risks, experts in the UAE told Khaleej Times what could go wrong, and why, and if there was a way to avoid complications and even stillbirth.

Dr Mandeep Singh, MD MRCOG, sub-specialist and consultant in foetal maternal medicine and CEO at Burjeel Farha (Women’s and Children) said that two of the most important decisions to make during pregnancy is to get access to healthcare as early as possible and to find the right doctor who specialises in multiple pregnancy.

“There are two things: one is early access to care, and getting access to the right centre,” he said, adding that it is important to understand that not every obstetrician can manage a twin pregnancy.

“Twin pregnancies need to be managed by centres that have experience in managing multiple pregnancies.

“Twin pregnancy is different from singleton pregnancy, and both the patients and doctors need to recognise that. Somehow, there has always been this culture that every doctor can manage the pregnancy. I think we need to move away from that.

“Twin pregnancy complications are very different from single term pregnancy. So screening for these problems and picking up problems at the right time and managing them in an appropriate way is the key to safe deliveries and safe outcomes.”

So how can one avoid complications that may lead to a stillbirth?

Dr Singh said one way is by “educating yourself, adopting a healthy lifestyle, access to the right doctors and proper plan of management are the three main factors.”

“So when you get access to good medical facilities, they will put all the things that are needed to make sure that the pregnancy is going well. These include booking a screening for chromosomal abnormalities, a screening for infectious diseases, a screening for diabetes, screening for pre-eclampsia, because these are the things that if found in someone at high risk, you can treat and make sure that they don’t have a poor outcome.

“There are things that we can do to prevent complications, and then, as the pregnancy advances, it is vital to keep looking for complications that may happen and managing labour appropriately. Labour cannot just be managed by one person. You need trained doctors, you need trained midwives, you need trained nurses looking after the patient.”

The specialist added that a scan is carried out every four weeks after 20 weeks gestation for non-identical (dichorionic twins) and every two weeks for identical twins (mono-chorionic twins) to rule out any complications.

Furthermore, he said factors that can make a pregnancy high risk include the mother having heart disease, having complications with the lungs or complications with the placenta, or suffering from high blood pressure in pregnancy or had some previous history. Other factors include the mother having suffered a previous loss of a child, or if she the previous delivery resulted in a baby below normal size and weight, or if the baby was born with some defect.

Dr Singh: “We do not know all the reasons why these babies die but the most common reason is because of problems with growth.

He added that some of the risk factors include gestational diabetes, high blood pressure in pregnancy or preeclampsia which can all cause stillbirth.

“Then there are certain blood disorders that can cause stillbirth. So it’s a very complex field,” he noted.

“The risk of stillbirth in identical twin pregnancies is 9 times higher than singleton pregnancies, and 4 times for non-identical (fraternal) twins.”

Read Full Story: Khaleej Times