Two placentae, three sacs & one placenta, three sacs

This checklist is based on the antenatal care pathway for women with uncomplicated TRIPLET pregnancy. You will have at least 11 appointments, which will all include scans which should take place in a twins/triplets clinic.

11-14 weeks
11-14 weeks
Booking appointment and dating scan 11-14 weeks
Information you should receive

Your midwife or doctor should give you information about:

  • Nutrition and diet, including vitamin D, Iron and folic acid supplements
  • Antenatal screening tests
  • Your pregnancy care pathway
  • Information on multiple antenatal classes
  • Specialist multiple support groups – Twins Trust, multiple birth foundation and local multiple groups
  • Parent information pack on multiple pregnancy
  • Healthy Start vouchers
  • Mental health and postnatal depression
  • Exercise, including pelvic floor exercises

 

The care you should receive

Your midwife, doctor or sonographer should: 

  • Carry out an ultrasound scan to estimate when the babies are due
  • Tell you what type of multiple pregnancy your pregnancy is
  • See if you may need additional care or support
  • Plan the care you will get throughout your pregnancy
  • Measure your blood pressure and test your urine
  • Offer you screening tests, make sure you understand what is involved before you decide to have any of them and discuss results
  • Discuss timing and how you’ll give birth and pre-term birth
  • Advise on use of aspirin if you are at risk of high blood pressure
  • Discuss and check any health issues that may affect your pregnancy

 

 

16 weeks
16 weeks
16 week appointment with a multiples midwife
Information you should receive

Your midwife should give you information about:

  • The ultrasound scan you will be offered at 20 weeks and help with any concerns or questions you have
  • Where to have your babies
  • Maternity benefits

 

The care you should receive
Your midwife should:
 
  • Review the results of any screening tests
  • Your specialist consultant should carry out an antenatal check and explain any risks for your type of pregnancy
  • Measure your blood pressure and test your urine
  • Discuss recommendations and choice for your birth and early labour and the importance of contacting your unit immediately if you have any concerns

 

 

18 weeks
18 weeks
18 week appointment with a multiples midwife and team
Information you should receive

Your midwife or doctor should help you with any concerns or questions you have.

 

The care you should receive

Your midwife, doctor or sonographer should: 

  • Carry out an ultrasound scan
  • Measure your blood pressure and test your urine

 

 

20 weeks
20 weeks
20 week appointment with a multiples midwife and team
Information you should receive

Your midwife or doctor should give you information about:

  • Antenatal triplet classes - information on any classes available for multiple pregnancies
  • Breastfeeding
  • Importance of babies movements and contact numbers

 

Your midwife, doctor or sonographer should:

  • Carry out a detailed ultrasound scan to check the physical development of your babies and discuss the results
  • Measure your blood pressure and test your urine
  • Carry out a blood test to check for anaemia

 

 

22 weeks
22 weeks
22 week appointment with a multiples midwife and team
Information you should receive

Your midwife or doctor should help you with any concerns or questions you have.

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine

 

 

24 weeks
24 weeks
24 week appointment with a multiples midwife and team
Information you should receive

Your midwife or doctor should give you information about:

  • Any need for experienced enhanced team referral e.g. physio, mental health
  • Provide a MAT B1 certificate – medical evidence of your pregnancy for your employer (any time after 20 week scan)
  • Booking antenatal classes

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan
  • Measure your blood pressure and test your urine
  • Carry out blood test for anaemia (if not already done)
  • Talk to you about the risks/symptoms of early labour

 

 

26 weeks
26 weeks
26 week appointment with a multiples midwife
Information you should receive

Your midwife or doctor should give you information about: 

  • Discuss any anxieties - re pending life change, demands of two or more babies and coping strategies, effect on relationships
  • Mental health and post-natal depression

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Discuss timing and choice of birth
  • Discuss anti-D treatment if rhesus negative

 

 

28 weeks
28 weeks
28 week appointment with a multiples midwife and team
Information you should receive

Your midwife or doctor should help you with any concerns or questions you have.

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Carry out a blood test
  • Discuss timing and type of delivery (date for induction or elective caesarean) if not already been discussed
  • Discuss and agree birth plan and include in notes
  • Discuss breastfeeding checklist
  • Organise a Health Visitor referral

 

 

30 weeks
30 weeks
30 week appointment with a multiples midwife
Information you should receive

Your midwife or doctor should give you information about:

  • Breastfeeding and postnatal care
  • What will happen during and after delivery

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Discuss and record the results of any tests
  • Discuss labour, birth and coping strategies (birth plan)
  • Measure your blood pressure and test your urine

 

 

32 weeks
32 weeks
32 week appointment with a multiples midwife and team
Information you should receive

Your midwife should give you information about:

  • Vitamin K
  • Newborn screening tests

 

The care you should receive

Your midwife, doctor or sonographer should:

  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Carry out a blood test

 

 

34 weeks
34 weeks
34 week appointment with a multiples midwife and team
Information you should receive

Your midwife should:

  • Discuss any anxieties and postnatal depression
  • Advise you on care provided by the multiples midwife once your babies are born
  • Provide information on:
    • Breastfeeding, including hints and tips for success
    • Caring for your newborn babies
    • Vitamin K and screening tests for your newborn babies
    • Your own health after the babies are born
    • What will happen during and after delivery

 

The care you should receive
Your midwife, doctor or sonographer should:
 
  • Carry out an ultrasound scan and discuss results
  • Measure your blood pressure and test your urine
  • Discuss induction of labour or caesarean procedure and offer course of steroids
  • Plan for birth at 35 weeks for dichorionic triplets following course of steroids. Timing of birth for monochorionic triplets will be discussed on an individual basis

 

 


At least 2 hospital appointments should be with a doctor who specialises in multiple pregnancies, one of which should be at 16 weeks.