Twins

Yes, that is correct, momof5, but on ultrasound two fused placentas look very similar to just one placenta. The doctor was not sure if it was one or two until we found out they were b/g at my 20 week ultrasound. So just saying you can see one placenta on ultrasound and still have frats. It was actually really cool to see the fused placenta at their birth.

 

That makes sense but they are definate that they are identical when there is only one chorion and 2 amnions, right?

 

I think she was saying that at times it can't be determined until after birth whether or not there are two placentas. Sometimes they are fused so closely that it is literally impossible to tell. I was told that also, but once we developed ttts it was clear there was only one.

 

ANYONE who is having twins sharing a placenta NEEDS to be seen by a high risk doctor!!!!!!!!!!!!!!!!!!!!

No exceptions. By having mono-di or mo mo twins, you are immediately deemed high risk. My OB didn't even see me! She sent me right to the Peri. I was seen TWICE a week.

TTTS is a very real problem and sneaks up w/o warning. It's nothing to be taken lightly.

Be seen as often as you can AND make sure it's by people with experience with TTTS.

As far as the NICU goes.. be in the hospital that has one and not just ANY NICU. Make sure it's a high level one. Again, better not to take ANY risks.

Good luck!! It's a wild ride!

 

I agree

 

I hope you don't mind but I think it is better to say that just because you only see one placenta on an u/s doesn't mean that there was possibly two placentas that fused at some point. However, one placenta does mean identical. I think that's why some people prefer to do a DNA test after birth to know for sure if their twins are fraternal or identical. Unless, of course the babies develop TTTS or are monoamniotic. Then you don't need a DNA test to know if they are identical

 

Definitely possible, although most doctors should be able to easily recognize a mono/di pregnancy from a fused dichorionic pregnancy between 10-14 weeks (if you have a scan at this time) by seeing the twin peak sign (lambda sign) which indicates a fused dichorionic pregnancy vs. a T shaped junction (which indicates a mono/di pregnancy). A perinatologist or MFM should easily be able to tell, but of course mistakes can be made (more likely by an OB who doesn't see a lot of ID twins).

 

Great point, especially about MFM. I do also agree that it depends on how much experience your ob/gyn or MFM docs have with id twins.

 

IrishLisa- great job on your pregnancy! I can't imagine how difficult it must have been going through a monoamniotic pregnancy but your girls did so well- 32.5 weeks at almost 4 lbs- fantastic! I am hoping I can get my IUGR twin close to 4lbs...hope that they are doing great!

 

Thank you so much!!!! They were pretty big for 32 weekers. Drink TONS of Ensure or Boost, it really makes a difference. Hope you are feeling well, I'll be checking on you

 

Thanks Lisa! I am drinking a few bottles per day...trying to get my little guy to pack on the pounds...he is hanging in there though! I've got 3.5 weeks to make it to my second goal of 32 weeks!

 

Hey there,

I'm 26 weeks pregnant with mono-di twins, and at 23 weeks they noticed a 24% difference between the two. I started off my prenatal care with a midwifery group locally, and they've been sending me to another hospital for ultrasounds and to consult with the perinatologists there. I'm hearing a lot of different things about what this growth difference means for the pregnancy, and am anxious about the treatment I've been recieving. I don't know how severe my case is--I feel like I'm hearing that this is "alarming," and I'm worried that I'm not being followed very closely. What has your experience been being monitored with unequal placental sharing?

 

Hello -
I'm new here too! 22.5 wks with mono/ di boys on bed rest for a funneling/dynamic cervix (found at 20 wks), which is doing better with bed rest, I'm seen by my perinatologist every 1-2wks with a cervical USG and USG for babies growth at each visit. Widgets - I don't have experience with unequal placental sharing, but I think whenever a complication arises its good to have the perinatologists involved. It seems like your not getting your questions answered...maybe there are not clear answers but the perinatologist should be able to explain what he/she is concerned about, the game plan for your visits, etc. I didn't really like my first perinatologist (poor bedside manner, too concerned with telling me about all the risks for the babies and didn't provide any info about diet or rest or anything that I could control). So I switched and found someone I really respect, who gives me time to ask a couple questions, and who explains everything clearly. I wish you well and I think that your questions are valid and should be addressed.

 

Hi Widgets,

I am sorry to hear about the unequal placenta sharing- it is certainly no fun to have complications. Since I have been about 11 weeks, my twins had approx. 16% difference in weight. At 26 weeks, it increased to 19% and at 28 weeks, it increased to 21%. At 28 weeks (well, 27w6d) my smaller twin was 1lb14oz and my bigger twin was 2lb6oz. The smaller twin was in the 16th percentile and the bigger twin was in the 40th percentile.

Let me ask you the following...

(1) is the amniotic fluid for each baby normal?
(2) does the smaller baby have normal blood through the umbilical cord?
(3) is the smaller baby below 10% on the growth curve?

Now, unequal placenta sharing is never good, but it is a lot better than TTTS. If they have ruled out TTTS, this is good news. What my peri has told me is that we are going to view each baby separately- as long as my smaller baby is growing normally (even though he is small) and he has good fluid and blood flow, he will stay in. It is ok for the babies to have a weight difference as long as the smaller baby is growing on his own curve. The major risk with unequal placenta sharing is that the baby will start getting abnormal blood flow and if the baby runs out of his/her share of the placenta. Thankfully, this has not happened with us yet. I have spoken with numerous other ladies who have had this problem (it's fairly common with ID twins) and most of the ladies actually went quite far into their pregnancies (earliest delivery was 31.5 weeks, latest was 37 weeks)

I've been on modified bedrest since 22 weeks (when our smaller baby dropped to 18th percentile) trying to improve blood flow and nutrients to the smaller baby. Starting at 28 weeks, I go to the dr. 2x a week for non stress tests and I get growth scans every 2 weeks. At 26 weeks, you should be seen every 2 weeks (at least) and they should be doing growth every 2-3 weeks. At 28 weeks, you should def press for non stress tests (at least 1x a week). If you have ANY kind of fluid discrepancy, you should have an ultrasound every week to check for TTTS. It isn't very common to get it after 24 weeks but it can happen (shockingly, a friend of mine was also pg with ID twins, 2 weeks ahead of me, and developed TTTS at 26.5 weeks- they had to deliver her babies at 26w6d). If you don't feel that you are being monitored closely enough- speak up to your peri/ob- you are your babies best advocate.

Please feel free to PM me with any questions or to share news- I know how hard it is to have complications in pregnancy. GOOD LUCK!