Confused- My OB and Perinatologist told me mono/di twins, tecnician said di/di?

So... history... only 12 weeks. My OB only saw 1 very early (5 weeks), then found twins.... 1st high scan at 7-8 weeks showed two, my Dr. said she thought they were almost positively mono/di because the membrane was so thin...

Had my first perinatologist appt. two days ago, he said 'definitely mono/di' when doing an u/s


Had my screening today, and the lady at East Bay Perinatal, outsourced from Kaiser) said she thought they were di/di because they have two yolk sacks? This doesn't make any sense to me, I thought that was only an indicator for mono/mono?

I am so confused now, we will love our babies no matter what, but I don't want to get my hopes up that they are fraternal. I tend to worry alot and since mono/di have so many more risks, I don't want to feel relieved falsely then get slammed with the worry about all the increased risks for mono/di.

The good news is according to them, I am 35 and the risk of Downs is over 1 in 5,000, and the risk of trisomy 13 or 18 is over 1 in 9,000! Yeah! I'm leaning to not getting an amnio, but it is up to my husband too (he is concerned about things screening doesn't measure). But, then again, if the lady was wrong, and did the measuring... I'm not sure I believe her results...

What do you ladies think? Who should I believe? Unfortunately, I don't have pictures.... (sigh)

 

Two yolk sacs only means they will MOST likely have a membrane separating them. I don't get why they don't know!! That is soo weird. Even I can see from an u/s picture if twins are in the same sac or not!! Can you post an u/s pic?? An early one preferrably? Usually, Di Di are kinda far apart and are clearly in their own black circles?? W/ ID's there is one black circle that they are BOTH in!! Let me know!

I could see that mine were in the same black circle at 7, 10, 11 and 13 weeks then they got too big and couldn't see a thing f/ u/s.

 

Oh and BTW-- Trust a Peri over an u/s tech. They aren't doctors. Glad to hear you are seeing a Peri.. if they are indeed Mo-Di-- you'll need high risk monitoring!!

 

QUOTE(ivfbound078 @ May 22 2008, 12:58 PM) [snapback]787870[/snapback]
Oh and BTW-- Trust a Peri over an u/s tech. They aren't doctors. Glad to hear you are seeing a Peri.. if they are indeed Mo-Di-- you'll need high risk monitoring!!



Thanks! Yeah, just started seeing one. Plan is to see him half the time and he will talk to my OB and see how comfortable she is with monitoring things like TTTS, and probably her half the time.

Can't post a picture- I will try to scan in the early one I have... but it was definitely two in a big, black space. I thought the amniotic sacs were placentas, I was wrong....

 

If your peri said the word "definately" one way or the other, I think that's about as solid an opinion as you can get. I could never pin any doctor or peri to the word "definately".
But remember that even if they're ID, the chances of anything happening are still rare. There are many, many women on this board with ID twins that had no problems whatsoever. The problems that I faced in the end are no big deal (just a fading memory). :hug99:

 

I agree to trust your OB/Peri over an u/s tech. And ask again at your next u/s.

 

QUOTE(ivfbound078 @ May 22 2008, 12:57 PM) [snapback]787862[/snapback]
Two yolk sacs only means they will MOST likely have a membrane separating them. I don't get why they don't know!! That is soo weird. Even I can see from an u/s picture if twins are in the same sac or not!! Can you post an u/s pic?? An early one preferrably? Usually, Di Di are kinda far apart and are clearly in their own black circles?? W/ ID's there is one black circle that they are BOTH in!! Let me know!

I could see that mine were in the same black circle at 7, 10, 11 and 13 weeks then they got too big and couldn't see a thing f/ u/s.


ID's can also have their own placenta and their own sacs, this is a common misconception. I would absolutely go with what the peri says, but if you are having real concerns I would call your peri and confirm it. That is what they are there for, you should be able to feel at ease through your pregnancy.

 

I agree that you should trust the peri over the u/s tech. I have had awful u/s techs also, which was one of the reasons I switched to a peri who is also an OB. I feel like a peri knows what they are doing over an u/s tech. Plus, if there is a question as to whether they are mono/di or di/di, I'd treat the pregnancy as mono/di and keep a closer eye on them just in case they are mono/di.

 

I had mo/di twins, and there were two yolk sacs.

Here's a pic of our u/s at 8w - as you can see there is one gest sac, and two babies in it. That means they are monochorionic, and because they has their own amniotic sacs (you could see a membrane between them) they were diamniotic. Did yours look anything like this?

http://i2.photobucket.com/albums/y2/colofisch/us1.jpg

I would definitely trust your peri/ob. I had an u/s tech tell me she thought she saw two placentas. Not so. By then we had TTTS so I was hoping that was true, but it wasn't.

Jenny

 

I also had mono/dis with 2 yolk sacs. I'd trust the docs more than the u/s techs who really aren't s'posed to interpret the findings.

Okay, I also have mild TTTS. But I feel like mono/dis and monos get a bum rap and everybody thinks they are the scourge pregnancy. There are plenty of ladies here who have had great mono/di pregnancies or are going thru it right now.

 

QUOTE(Mum2TwinBoys @ May 22 2008, 01:41 PM) [snapback]787985[/snapback]
ID's can also have their own placenta and their own sacs, this is a common misconception. I would absolutely go with what the peri says, but if you are having real concerns I would call your peri and confirm it. That is what they are there for, you should be able to feel at ease through your pregnancy.



This is very true.. they CAN have their own EVERYTHING.. However.. if a Doc is saying they are ID- the oNLY way he/she can know this at this point is if they are in the same sac. That is why I said-- the 2 yolks only means most likely there will be a membrane.

A Peri would NEVER say they thought they were ID at this stage (or shouldn't unless they are psychic), unless they were in the same sac.

 

I don't think it is actually a question of the sac. On an early U/S, if it is determined that there is only one (and truly only one) placenta, then they are mono. Di means two sacs (including having only a thin membrane between the two.)

The placental status can often be determined through an early U/S. The farther you are into the pregnancy, there is a higher chance that two placentas can either either fuse together or move close enough together to appear as one.

 

At the very first ultrasound I had at 7 weeks 5 days, my OB told me that we had di/di twins. She said that she saw a seperating membrane. I did not think I had anything to worry about with TTTS or anything like that. I was monitored normally but only by my OB. I never once saw a peri.

I had a very uneventful pregnancy. It was great.

When I had the babies, they pulled out one placenta, and my babies looked very much alike. My OB said that my placenta must have fused together. Pathology report said that I had one placenta the entire time and that in fact I had mono/di twins and that my doctor was wrong.

I am happy that I didn't know because I probably would have been super worried about TTTS, but I think like a PP said, you have to believe that everything is going to be okay because chances are that it will be okay.

 

yup.. I have MO/Di as well with 2 yolk sacs. Sharing 1 placenta was the only way they could tell me for sure that they were mo/di. I think I would trust the OB and Peri over the u/s Tech. sounds like that Tech didn't really know what she was talking about.

 

QUOTE(denali_ice @ May 23 2008, 06:48 AM) [snapback]789209[/snapback]
I don't think it is actually a question of the sac. On an early U/S, if it is determined that there is only one (and truly only one) placenta, then they are mono. Di means two sacs (including having only a thin membrane between the two.)

The placental status can often be determined through an early U/S. The farther you are into the pregnancy, there is a higher chance that two placentas can either either fuse together or move close enough together to appear as one.


I am not sure about this. They cannot "see" a placenta this early in the game. The only way they can see that they are identical twins (THIS EARLY) is if they are in the SAME sac. There is no placenta visible placenta this early-- the yolk sac IS the placenta this early. I only know this because I did IVF and was with a Reproductive Endocrinologist and had MAJOR early ultrasounds done about 3 times per week. I was soooo enveloped in the whole infertility thing that I questioned EVERyTHING!!

If you google the two and look at u/s photos (early on) you can very easily see two DISTINCT black circles w/ one baby in each for FRAT twins- and for ID's ONE black circle w/ two babies inside of it... I think the confusion is coming in when the people are further along.. at my 7 and 10 week u/s it was totally clear that there was one black circle with two babies inside of it-- at this pt you can't see placenta or membrane or anything except two beans in one black hole. The person above who posted an u/s picture is a perfect example of this... If someone could post an u/s pic of their frats that would be helpful too. There is an obvious difference and that is how docs tell at 7 weeks.. NOT by placenta--- not visible yet!! *I am talking at 10 weeks or before*

Here is an ultrasound of ID (mono di) twins and it's VERY clear they are in one "black hole" http://www.youtube.com/watch?v=XtkIhKCi37A

Now HERE is one of Fraternal Twins... (Note the TWo distinct 'black holes') Hope this helps!! http://www.youtube.com/watch?v=stUV5Jrg5e0...feature=related

 

Well gee, apparently I don't know what I am talking about since at my 9 week U/S they were about to see and determine one placenta. So, whatever. You are the one who asked.

 

Congrats on your babies!! We didn't go for our first visit until we were 10 weeks along. It was then we found out we were having twins. They only told us that they were in two separate sacs and they had a membrane in between. I think that was what they were most concerned about was ruling out the mono/mono. At our scan 5 weeks later they told us that the placenta did not looked fused (there are usually signs or markers that show that it has fused) and that the membrane in between was super thin. This led them to the diagnosis of mono (one chorion)/di (two amnions). This is the most common way identicals are in the womb. Yes it does raise the risks, but chances are everything will be ok. I am being seen every two weeks and get a "check-in u/s" and a growth scan each once a month. If they begin to see problems then they will adjust the care. I would listen to the OB and peri over the tech. Maybe she was assuming that the placentas fused together. I was told to increase my protein intake and start on protein shakes to add to the twins growth, which I have done and my boys have been consistent in measuring a week big. Let me know how it goes the next time you go to the doc. Good Luck. Melanie

 

I was going to add that at 9 weeks, my OB said, "I'm 99% sure they are mono/di. See how thin that membrane is?" I don' remember the measurement, but it was very thin. I think they can do a measurement that gives them a fairly good clue.