Twin Pregnancy at 23 Weeks: Pressure, Back Pain & Concerns

Question
Hello,

I am 29 years old and 23 weeks pregnant with twins.  This is my first pregnancy and I am also a very tiny person, 4'11" and pre-pregnant weight of 98lbs.  This pregnancy has been rough on my body thus far and I have been complaining of extreme pressure down very low for the past 2 months and bad back pain.  I am a teacher and have been working half days for awhile but I feel horrible by 9am and the pressure and back pain are pretty bad.  I have had no spotting or contractions thus far.  At my 20 week appt. there was an increased amount of amniotic fluid and my cervix was measuring at a 2.8.  My doctor says that everything looks fine and that I should be up and doing things as normal. After reading on the internet, it seems to me that we should be a little more concerned.  What are your thoughts?

Answer
If everything else is normal, I suggest that every patient carrying twins be on bedrest after 28 weeks gestation. The biggest problem with twin pregnancies is the risk of preterm labor. Any time that the length of the cervix is less than 3cm, the risk of preterm labor increases. If you are having extreme pressure, a shortened cervix, and back pain, I would stop working and stay on bedrest with bathroom priveleges. Although some studies show that bedrest does not  prevent preterm labor, patients who were on bedrest appear to do better, overall.