29 week apt update & questions about u/s follow ups for TTTS

I haven't really posted any updates in a long time
Here is a little background.
I was diagnosed with TTTS at 14 w (they were 5 days apart then). I had subchorionic bleeding at 16w which finally stopped at 24 w. At 20w during a routine u/s, the doc rushed me to L/D, since I was dilating and contracting. After a few hours of observation, IV fluids and niphedipine I was sent home on strict bedrest and niphedepine regime. The dilation has stayed at 1-2 cm, with cervix length varying from 4.3 to 3.9cm. Once I completed 28 w the doc said I could now go to modified bedrest and venture out for a small 5-10 minute walk (if I can muster the strength).
So today at my 29w u/s, Twin A is 3lbs 1oz and Twin B is 2lbs 15 oz. The doc said this difference was fine.
Here are some things that are bothereing me
1. I was having u/s every 2 weeks but the doc wants me to come back after 4 weeks for next u/s (I'll be 33w then). He days that now the chance of TTTS showing itself are very slim. But from a lot of posts I have read, some developed TTTS late in pregnancy. I am really scared about that. Your thoughts/ comments.
2. The Twins measured at 30w 1 day and 30w instead of 29w. Is that normal.
3. I am really scared of moving around a lot, since I am scared it will accelerate PTL (doc says it wont matter now)
4. The docs wont go past 38w for delivery. I also read some threads about mono/di should be delivered by 36w since waiting further may cause complications.

Your thoughts/comments??????????

 

I don't want to worry you but I personally wouldn't be real comfortable with some of that. I too was diagnosed just over 14 weeks and was seen weekly the entire time some weeks 2-3 times. I'm not a doctor but I was always of the understanding it can happen very quickly. We stayed stable for the most part but they wanted me under constant observation just in case we took a turn for the worse. One week we'd be doing ok the next week things would start to get bad. We were ready to deliver anytime after 24 weeks if we went bad. But as long as everything was going ok they would try to get me to 36 weeks and no longer. We did make it that far and I was induced and had two healthy babies. You can develop ttts all the way up to and during delivery. I would think you are at a critical part now that if you suddenly took a bad turn they could deliver and get them to the nicu and take care of them. I wouldn't be able to sleep if I were to have to wait 4 weeks. At that point just waiting 48 hrs to see the doctor and put my mind at ease was all I lived for. good luck!

 

I would push for u/s every 2 weeks. It's not that TTTS cannot show itself, it is that if it DOES, you can deliver instead of do the laser surgery or something else. TTTS can appear anytime - many babies come out red and pale and the drs say "huh, that's TTTS" - like they couldn't have known all along.

I think it's normal for your babies to be measuring ahead. That's great! Mine were always behind.

I encourage you to stay on bedrest as much as you can, especially if you're worried about TTTS. Also, boost your protein intake.

Also, IF you are monitored closely, maybe you can go to 38w or more. I delivered at 38w4d, but I was monitored very closely, and I had TTTS but it had been stable, and we got at least weekly u/s, if not more often.

If you have more questions about TTTS, go to the TTTS foundation website and call Mary about this - she will help you. Also, she may get you (and maybe your dr) in touch with Dr. delia who will also help you.

hth
jenny

 

I would keep yourself on bedrest as much as possible and maybe have your hubby work with you on some stationary movements so your muscles don't get weak and sore. I would tell your doc that you are uncomfortable and want to have an u/s every 2 weeks. I thought it was more the other way around, you are seen more often toward the end of your pregnancy? You need to go with your gut and be upfront with your OB-you can always switch doc too if you're not happy. Good luck

 

I was on hospital bedrest cause of TTTS since week 22 and had daily, yes daily u/s cause it can happen so fast.

In fact, I had what seemed to be a "normal" u/s read by one dr one day, the next day another dr came, freaked out, made me rush to get a u/s and I had to deliver right then and there!

I would push for more followup, just my opinion. Good luck and keep us updated!

 

Thanks ladies..........I'll call the hospital and ask the doc to see me every 2 weeks