Every pregnancy is different, and your body is doing something incredible. Pregnancy can present itself with various symptoms.

Anaemia occurs when your blood doesn’t have enough healthy red blood cells to carry oxygen to your tissues and to your baby. Symptoms are feeling tired, looking pale, being short of breath and fainting. A diet rich in iron will help keep haemoglobin levels up. Foods to go for are red meat, lentils, haricot beans, dark green vegetables and breakfast cereals fortified with iron. You can also take supplements (if they cause constipation, get plenty of fluid and fibre; changing brand may help).

Symptoms include a rise in blood pressure and/or protein present in urine, so both of these will be regularly monitored. It may be associated with symptoms such as swelling of the face, sudden swelling or puffiness of ankles and hands, severe headaches, affected vision, and in more severe cases, pain in the upper abdomen. If you suffer any of these symptoms, contact your healthcare team immediately. You may need hospital care and bed-rest to reduce the blood pressure, and in severe cases the babies may need to be delivered early. If this happens, steroid injections may be given to help their lungs develop before being born.

The physical symptoms may at first seem like preeclampsia but HELLP syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine aren’t present.

Pregnant women develop HELLP syndrome have reported experiencing one or more of these symptoms.

Headache, nausea/vomiting/indigestion with pain after eating, abdominal or chest tenderness and upper right side pain, shoulder pain or pain when breathing deeply, bleeding, changes in vision and swelling.

HELLP syndrome can be life-threatening so it is important to seek medical help urgently. Both Hellp and preeclampsia usually occur during the later stages of pregnancy or sometimes after childbirth.

Most often the definitive treament for women is the delivery of their baby.

Catherine's story - HELLP Syndrome whilst pregnant with twins
Catherine wants to share her story to raise awareness of the condition, not to scare people as HELLP Syndrome is rare. Her fraternal twins Grace and Amelia are doing well.
Getting HELLP
Twin mum Katie Baker is keen to raise awareness of a rare disorder, HELLP.

The most common gestation for the onset of labour in twin pregnancies is approximately 37 weeks.  However, labour may occur earlier than this, particularly with multiple births. The signs and symptoms of preterm labour are regular contractions of the womb, building up in strength and frequency, sometimes with passage of the mucous plug (‘show’) or breaking of the waters.  Premature tightening (often referred to as braxton hicks) are a common occurrence in pregnancy, particularly with twins and triplets, and in most cases they are not a sign of preterm labour.  However, it can be very difficult to determine if labour is imminent or not and if you experience these symptoms along with pain you should inform a health care professional immediately.  It is likely that you will be advised to go to hospital.  Although it is difficult to stop true premature labour, it can sometimes be delayed, giving time to prepare the babies for an early birth.

This is high blood sugar during pregnancy which is caused by your body not making/using enough insulin. Symptoms include feeling very hungry or thirsty, needing to pass urine frequently, tiredness and blurred vision. These symptoms are not always noticeable, hence the need for regular urine testing at antenatal appointments. Gestational diabetes shouldn’t be a problem once it has been detected. Treatment involves dietary changes, close monitoring and sometimes medication in tablet form or insulin.

One in four multiple mothers in a Twins Trust survey reported some vaginal bleeding or spotting in pregnancy. It is usually harmless. However, it is essential to tell your doctor immediately should it happen to you so that serious complications – such as ectopic pregnancy or problems with the placenta – can be ruled out.

This is a liver condition where the normal flow of bile is impaired and bile salts build up in the blood. The main symptom is severe itching, often on the hands and feet. Other symptoms are fatigue and sleep deprivation from itching, loss of appetite, dark urine and/or pale stools, and mild depression. The treatment involves regular monitoring and medication to reduce the bile acids in the bloodstream. It is sometimes necessary to deliver the babies early to protect them. You can help your body by cutting down on fatty and fried foods so your liver has less work to do. Drink lots of water. Keeping cool may reduce itching, as may a cool shower and soaking your hands and feet in icy water before bed.