Biophysical Profile

Ok.. so I called my peri on Monday and complained about baby B not moving. Her nurse told me to go to the nearest hospital's L&D for triage. They did a NST and said that it was fine and sent me home before even seeing a doctor. (This is not my regular doctor btw.. I went to the nearest hospital like the RN told me). I went in for my regular OB apt. today and my peri yelled at me for going there. She said she would have rather had me drive the extra distance so she could have taken care of me. Anyways she was concerned about baby B's lack of movement and brought a bedside U/S into the room. After looking for a while she decided to get me into a regular U/S room to do a biophysical profile. Baby A (who is very active) scored 10/10 and Baby B 6/10. Baby B is not making the breathing motions or moving by herself. We were able to get her to move her legs a little bit after they made me roll over, raise my knees to my chest and do pelvic lifts several times. Baby B is also now 20% larger than Baby A (again). Her bladder is MUCH bigger than Baby B's still. I'm so frustrated this was getting all better and now all of a sudden things have gone to hell. She still has a lot more fluid also (which is why I figured I wasn't able to feel her moving). It's apparent to me now that the reason I don't feel her moving is because she isn't moving. So I was sent home with the same instructions as always.... Lay down a lot, drink lots of ensure and weigh myself every day to monitor for excess weight gain. I don't know what to do. My next U/S isn't for 2 more weeks and I just wonder if any of this is going to help. I can't imagine waiting for the next U/S to come but then again I don't want it to come to find that there is no longer a Baby B.

 

Please keep us posted on how your Baby B is doing :hug: I can imagine wanting and also dreading (at the same time) the next u/s, being afraid of the news you might get. It's hard not to be worried but I would follow what your peri says. Thinking positive thoughts for you and your babies :hug:

 

:hug: baby b was my smaller baby but still had movement issues. She never moved as much as baby a due to poor blood flow. I know its stressful but hang in there. They had me on twice a week monitoring

 

:hug: Momma! I cannot even imagine how worried you are right now! I hope everything continues to improve, and you are back soon to update with good news about Baby B! Don't hesitate to call your Dr or go into L&D if you are concerned. Listen to your gut! :hug:

 

:hug: Keep us posted. I can't imagine how hard this is for you waiting and worrying about it. :hug:

 

Are they avoiding suggesting the surgery for some reason? I know one should never rush into surgery, but I'm just wondering if there's a particular reason. My babies were diagnosed with TTTS at about 20 weeks, too, and the next day I ended up getting surgery. (At Evergreen Hospital in Kirkland, WA) It turned out really well for us, they were recovering the next day, and have been fine since.

 

That's a very good question. When they were at 20% back at 20 weeks she said that I would probably have to have surgery later on but she wanted to wait a bit to see if it could resolve itself with bed rest and protein. (The main concern then was actually that we couldn't see Baby A's bladder and she hardly had any fluid around her.) It was getting better for a while. Our apt. before today there was only a 16% difference and both bladders were visible. So today they are back at 20% difference. Baby A's bladder is visible and she has enough fluid, baby B's bladder is really big and she has lots of fluid. I didn't figure to ask about the surgery because I know last time we were at 20% she wanted to wait it out to see if it was going to get better or worse. What was the size difference at when you had surgery? Could you see both of their bladders? I really didn't even to think it could be the TTTS that may be causing Baby B's problems now. I haven't heard from anyone with TTTS that has had problems with breathing or movement. She said that with TTTS if Baby B gets too much fluid her heart could have difficulty pumping it but the NST part was fine so I figured it was non-related.

 

When I got the TTTS diagnosis, the donor's (baby B) bladder was pretty much invisible, and she was kind of plastered against the side of my uterous not moving much. The fluid around her was so low that the membranes were kind of stuck up against her and they could hardly see the membrane. The recipient's (baby A) fluid was a lot higher (sorry, can't remember if I heard any exact measurements) and her heart was enlarged. She was moving around a decent amount.

During the surgery they severed 18 veins that were connected in the placenta, and removed some of the excess fluid. The next morning, maybe about 20 hours later, they were both moving a healthy amount, baby B's bladder was normal sized, and baby A's heart looked normal, as well.

I know there are slight chances of risks, but since it worked so well for us, it makes me wonder why more people don't have that advised to them to do it.

P.S. I do remember hearing that before the surgery, the donor was estimated at 11 ounces, and the recipient at 13 ounces. Right now they are both at the expected size for the length of gestation.

 

I would be worried if I were you too. It is so hard to sit and wait for the next appointment wondering if they are okay. I am like you, they give me something to worry about and then I go back and it is resolved but then they find something else for me to worry about! Would your doctor be open to NST once or twice a week? In response to someone's question about surgery, I was told by my peri that the lastest they could do surgery for TTTS is 26 weeks. Not sure if that is the same everywhere but it is worth asking your doctor. Good luck and I hope everything turns out okay!!

 

I'm a HUGE believer in being your own advocate. If 2 weeks feels too long to you, make them give you an u/s or find someone who will. I'll definitely keep you in my prayers! Just remember, you have mommy intuition on your side. You know these babies better than anyone, so if you're worried, make sure they keep an eye on you.