What should you know about IUGR in twins?

Twin pregnancies naturally require closer observation because the babies may not grow at the same pace. A size difference can be related to placental sharing, unequal blood supply or a problem affecting one baby. The ultrasound team records each baby's measurements, fluid pocket and circulation, then compares results with the correct gestational-age references. A difference in size is a finding to investigate, not proof that either baby will become unwell.

Keep the appointments offered by your specialist team and ask how each baby is being labelled on the scan report. Learn the movement pattern expected for your pregnancy and report a clear change. Follow advice about blood pressure checks, medicines and activity. Visits may include a [Growth Scan](/treatments/pregnancy-and-birth-care/growth-scan/) and [Fetal Heart Monitoring](/treatments/pregnancy-and-birth-care/fetal-heart-monitoring/), with separate results for each baby.

Contact your maternity unit promptly if movements from either baby are reduced or noticeably different, or if you have bleeding, fluid leakage, regular contractions or significant abdominal pain. Severe headache, visual changes or sudden marked swelling also require urgent assessment. In a twin pregnancy, do not try to identify which baby is moving less before seeking advice.

Ask whether the twins share a placenta, which baby is smaller, and how their growth and blood flow compare. Ask how often scans are planned, what movement changes should trigger a call, and what birth options may be considered. If delivery becomes advisable, ask whether [Induction of Labour](/treatments/pregnancy-and-birth-care/induction-of-labour/) is appropriate for your situation.