25% discordance

I am 31 weeks 5 days with mono/di girls. We went today for a growth scan and got some not so good news.

Baby A is 3 lbs 2 oz (which is a 12 oz gain from our last growth scan 3 weeks ago)
Baby B is 4 lbs 3 oz (which is a 1 lb 8 oz gain from our last growth scan)

Baby B also has a really good level of fluid while Baby A while a normal amount is MUCH lower.

Their discordance went from 12% at their last scan to 25% this scan, the peri said that because Baby A is technically still with in normal limits he's not as concerned as he'd be if she was no longer in normal range but he did say that they are concerned that there is over a lb difference between the girls at this point.

They will have me coming back in next week for a fluid and doppler check and have set our next growth scan for August 20th which is another 3 weeks from now.

I'm stressing out and worried and I guess I'm looking for advice from mommas who have been there done that before.. what should I expect?

 

take a deep breath & try not to worry! :hug: at 27 weeks they found a fluid discordance between my girls (also mono/di) - my baby B's fluid suddenly went way up, while baby A's stayed the same. it was definitely an anxious time & we had increased monitoring of the pregnancy. in the end, it wasn't anything at all. also, my girls were born with a 1.5 lb difference between them. so while it could be something, it also could be nothing. it sounds like your doc is keeping an extra close eye on things & that's a good thing. :hug:

 

You have a few things going for you...1) they're monitoring you appropriately, 2) You have carried them to a gestational age that they could be delivered with fewer complications, and 3) they're girls

It's normal for them to schedule growth scans that far apart. Otherwise the measurements wouldn't be as accurate. If they haven't mentioned it already, I would ask (INSIST UPON) for weekly dopplers from here on out. As long as their dopplers are okay then try not to worry.

I'll be keeping you and the girls in my prayers.

 

I have been getting weekly dopplers for 2 months now and will continue to do so for the remainder of the pregnancy as far as I know. There is something weird going on with Baby A's Doppler levels, only in one spot on her cord but they don't really know what's causing it. They said they weren't overly concerned with it because she was growing appropriately, fluid levels were good, and she is nice and active but now she's not growing well and her fluid level is dropping so *I* am worried (not that it means anything that I'm worried other than I am overly paranoid about something going wrong)

I do take solace in the fact that if something starts to look off the girls could be delivered now and have little long term complications.

This pregnancy has been so much more stressful than I ever thought it would be. Good thing I only have 45 days to go so.

 

do be aware that measurements can be up to a lbs off. My girls were born around 50% discorandence at a planned c-section to prevent fetal death in my smaller daughter. Jessy weighted 2lbs 13 oz and Jazz weighted 4 lbs 9 oz. Your girls seem to have pretty good weights at this point. Have they been monitoring the smaller babies cord flow? Jess only had a 2 vessel cord and insuffient blood flow but never negative flow

 

They have been monitoring their cord flows. And Kaeda (our smaller baby) has elevated doppler flow where the cord comes into her abdomen but no where else. Almost like it's meeting resistance. But until this scan there was never any reason to be concerned about it other than to keep monitoring it because as the peri put it "she may have a problem with her cord flow but no one has told her". Her heart still looks good, fluid levels are normal although they have dropped significantly. (Baby B had fluid level up over 9 and Baby A had fluid level just over 5). I am lucky that they are being extra cautious with them but with my history (my first pregnancy ended with induction due to severe IUGR and she didn't survive)I don't think I'll be able to calm about it all until they are here and healthy.

Thank you for reminding me about the weights being only guesses and not necessarily accurate. See I need common sense to return but I think mine has taken a permanent leave of absence at this point. LOL

 

I don't have any advice, but good luck, hope they keep monitoring and things improve.

 

It sounds like it could be the start of Twin to Twin. I would just make darn sure you are drinking a ton of water, resting as much as possible with feet up and going for those weekly checks. I am very sorry for the loss of your first daughter.

 

Jessy had good heart scans in utero but after she was born she had a murmur and they found a hole at 4. We had similar fluid levels, enough for them to watch for ttts but never enough for them to be really worried about it. From 24 weeks(found out it was twins) till 34 weeks, I was on strict bedrest due to the IUGR. We delivered at 34 weeks to prevent fetal death. At 24 weeks they told me I would most likely never carry her to term.

 

How were they at 34 weeks? My next growth scan is August 20th and I'll be 34 weeks then and have a very strong suspicion that they'll decide at that point that the twinkies would do better outside than inside but I'm so nervous about 34 weekers.

 

Jessy was tiny but we had had shots at 26 weeks for their lungs. Jessy required no O2 but we had Jazz on for 2 hours. They were a bit juandice and had to stay under the lights. They had to work on the suck swallow reflex and neither ever wanted a paci. We had to tube feed Jessy for at least the first week and part of the second week, she just got too tired. Jazz came home at 15 days and Jessy came home at 3 weeks exactly. At our hospital they have to be 4lbs 4 oz to go home and we had to wait till Jess weighted enough to take her home. We did not go out any for the next 2 months for fear of rsv

 

I say pack your bag and be ready for delivery at your next scan!! :ibiggrin: 34 weekers tend to have such great prognoses (even IUGR babies) that peris will often recommend delivery at 34 weeks when there are any problems. So if you do have 34 weekers, be very very happy about it, know that the NICU stay is not forever, and expect that soon your babies will be home and doing great. And yay that you don't have to deal with RSV right now!

 

My situation wasn't exactly the same as yours (what 2 pregnancies are anyway?), but I wanted to share a positive outcome. My boys were mono/di and had an almost 30% discordance in growth at one point (around 30 weeks). At that point, both of their fluid levels were still within the normal range, though B's were on the low side of normal. We went to weekly fluid and growth scans at that point to be on the safe side. Over the next few weeks, the difference slowly went down and their fluid levels slowly regulated as well. In addition to sharing a placenta, baby B had a velamentous cord insertion (at the edge of the placenta), which could have caused the difference in size. However, at our last growth scan at 35 weeks, they were estimating their weight to be within a few grams of each other. I delivered at 36 weeks, which was the latest my peri would let me go with mono/di twins. Despite their last ultrasound, they were actually 14 oz different in weight at birth. Near the end, they are so squished in that it is hard to get good measurements. We did have a 12 day NICU stay for baby A (my big boy!) due to respitory distress syndrome, but no other issues for either one. Good luck and I hope your next scan shows improvement!

 

Just wanted to say...my 34 weeker only spent 1 week in the nicu and did just fine. Everyone pretty much covered it. When I was diagnosed at 20 weeks I would have done anything to be 32 weeks..so that they could be delivered.

 

I just gave birth to my mono/di boys 5 days ago at 33 weeks 6 days. They've had unexplained size discordance since week 18. It varied in percentage but usually about 20-25% difference and Baby B was diagnosedcwith IUGR. Fluid was always good, no TTTS and really no explanation for their size difference. They are small, 4 lbs. 2 oz. And 3 lbs. 2 oz. at birth, but they are healthy and strong and really doing great. They're currently in the NICU but just working on growing and feeding and we're hoping they'll be able to come home on a week or so. Good luck at your appointment and try not to worry. If your babies are born at this stage, they reallly should be fine.