How and why did you start seeing a Peri?

From what I have been reading, it seems like most of you are seeing a peri. How did you first start to seeing him/her? Did you call on your own or where you refered to one by your OB? Why did you start going? Did your OB set you up with one as soon as you knew you were having twins? Is it considered routine for twin pregnancies to see a peri or did you start going because of complications?

I'm asking because I'm only being seen once a month right now by my OB and I have a u/s once a month also. So, I either seeing the OB and or get an u/s every two weeks. When I asked about seeing a peri or having more frequent u/s, the OB said I did not need either unless complications develop. He did offer for me to just go talk to the peri if I wanted. I think I will at least do that and try to weasel my way into more u/s. I am having mono/di twins, so I'm getting concerned about TTTS, especially because I'm the one with the stupid u/s tech who told me I'm having mono/di twins but she can't be sure they are identical! I really don't know if she knows what she is doing!

 

We started to see a Peri at about 18 weeks. My OB referred me to see the Peri. because of "Advanced Maternal Age"...I had just turned 33 during my first trimester and because of multiples. It was nice to see a Dr every other week from the beginning of the second trimester onward. I found that I always had questions and it was nice not to have to wait too long to have them answered. I am very glad I did and I would push to see one if you can.

 

QUOTE(marisa55 @ May 9 2008, 01:41 PM) [snapback]764597[/snapback]
I am having mono/di twins, so I'm getting concerned about TTTS, especially because I'm the one with the stupid u/s tech who told me I'm having mono/di twins but she can't be sure they are identical! I really don't know if she knows what she is doing!


:wacko:


I started seeing a peri at 12 weeks. My OB said to go, so I went. When they found out I was having twins, they put me in the high risk catergory {though no other reason then it being twins}. My OB referred me to the peri and I was seeing them once a month, along with seeing my OB once a month.

 

I was referred to my Peri at my first OBGYN appointment at 9 weeks. I have been seeing a peri since I was 12 weeks. My OBGYN considers a multiples pregnancy high risk; that is why I was referred to the peri.

 

I just now started seeing a Peri.. 2 days ago.. Mine was because one of my girls was measuring a bit behind. I talked with my MW and told her I would like a consult with a Peri to make sure everything was ok.. she just happened to agree with me and I am very glad I saw him as he wants to see me weekly to monitor the babies.

Even when your OB or MW does not think there is reason.. they aren't the specialist and really the only way to know if you need to see a Peri is to get a consult with one.. so I would go ahead and ask your OB to set that up for you and go from there.

 

I originally went to the peri for my NT scan - but at that visit, we found out we were having twins! I'm considered high risk because of my age (38) and twins - so he did a quick twin consult the day of the NT and has been following me ever since.

 

My OB refers twin pregnancies to a peri, so I first saw mine at 8 weeks, a few days after my first OB appt. where we discovered the twins.

Because everything was going so smoothly at that point, I didn't see the peri again until 20 weeks; since then it's every 4 weeks unless something comes up that he'd like to monitor more closely.

 

Thanks. I will set up an appointment with a peri.

 

QUOTE(twins make 9 @ May 9 2008, 11:51 AM) [snapback]764625[/snapback]
Even when your OB or MW does not think there is reason.. they aren't the specialist and really the only way to know if you need to see a Peri is to get a consult with one.. so I would go ahead and ask your OB to set that up for you and go from there.


I've been wondering about this too. I'm seeing my OB monthly but she keeps telling me if there's anything up in that time I can come in at two. I'm also going u/s once a month now, but they're really close to my OB visits. I was told at my u/s monday that I'm not really at risk for TTTS because my boys are in two sacs with their own placentas, and they're growing at the same rate and are right where they're supposed to be. So far everything looks good, but I'd hate for something to get over looked. Do you think I should just keep going the way I have or consult a peri?

 

QUOTE(Vivian @ May 9 2008, 06:19 PM) [snapback]764683[/snapback]
I've been wondering about this too. I'm seeing my OB monthly but she keeps telling me if there's anything up in that time I can come in at two. I'm also going u/s once a month now, but they're really close to my OB visits. I was told at my u/s monday that I'm not really at risk for TTTS because my boys are in two sacs with their own placentas, and they're growing at the same rate and are right where they're supposed to be. So far everything looks good, but I'd hate for something to get over looked. Do you think I should just keep going the way I have or consult a peri?


Has your cervical length been measured via T/V U/S? I think this is a very important thing that peris do, but OB's do much less often.

 

QUOTE(Babies4Susan @ May 9 2008, 02:34 PM) [snapback]764715[/snapback]
Has your cervical length been measured via T/V U/S? I think this is a very important thing that peris do, but OB's do much less often.


Mine hasn't been. When do they usually start taking that measurement. i'll be 17 weeks on Monday. Should they have done that already?

 

I never saw a peri and I pretty much went full term with my twins. No NICU time or anything like that, I delivered 12 pounds of babies. Just because you are pregnant with twins does not automatically make you high risk. If you trust your OB then maybe you can trust his or her medical opinion that you don't need to see a peri.

 

QUOTE(DATJMom @ May 9 2008, 12:45 PM) [snapback]764607[/snapback]
We started to see a Peri at about 18 weeks. My OB referred me to see the Peri. because of "Advanced Maternal Age"...I had just turned 33 during my first trimester and because of multiples. It was nice to see a Dr every other week from the beginning of the second trimester onward. I found that I always had questions and it was nice not to have to wait too long to have them answered. I am very glad I did and I would push to see one if you can.


I saw mine first at 12 weeks for the nuchel - I am 35 so I am that "Advanced Maternal Age" as well. My twins are in seperate sacs, but sharing a placenta, so they will monitor for TTTS. The ultrasounds are more advanced as well, so that is nice. The other plus is more opportunity to see my little magic beans ... that's always nice !!!

 

QUOTE(marisa55 @ May 9 2008, 01:57 PM) [snapback]764754[/snapback]
Mine hasn't been. When do they usually start taking that measurement. i'll be 17 weeks on Monday. Should they have done that already?


Don't let other people's stories freak you out. Your doctor is probably competent. They probably are measuring your cervix every time they do an u/s and just aren't telling you about it. Call your doctor and ask. I didn't realize mine was being measured but that's one of the things they measure when they do an u/s at my OB's office.

 

QUOTE(aimeethomp @ May 9 2008, 03:04 PM) [snapback]764766[/snapback]
Don't let other people's stories freak you out. Your doctor is probably competent. They probably are measuring your cervix every time they do an u/s and just aren't telling you about it. Call your doctor and ask. I didn't realize mine was being measured but that's one of the things they measure when they do an u/s at my OB's office.


Thanks. I'll ask. They probably are and I didn't realize it.

 

I started seeing a peri at 10 weeks just due to having twins, my OB recommended I see the him and the peri. I was not high risk otherwise.

 

My OB referred me to the peri for my big 18 week u/s. I think my OB's office automatically sends all multiple pregnancies to the peri to be monitored. They get a report after each u/s. I've seen the peri once a month since then for a growth scan and they also did an internal u/s to measure my cervix until 30 weeks. Then, I started seeing the peri every 3 weeks. I just go for a growth u/s and I get to talk to the peri at the end of each visit to go over everything. I feel better being seen by a high-risk doctor as well as my OB. Why not? It doesn't cost me anything extra. I love being able to see the babies every month and I even got a free 4d u/s around 28 weeks. If you have the opportunity to see a peri, you might as well. You have to do what makes you comfortable. If you are at risk for TTTS, then I would definitely want to be monitored by a peri. Good luck with your pregnancy.

 

QUOTE(aimeethomp @ May 9 2008, 02:02 PM) [snapback]764762[/snapback]
I never saw a peri and I pretty much went full term with my twins. No NICU time or anything like that, I delivered 12 pounds of babies. Just because you are pregnant with twins does not automatically make you high risk. If you trust your OB then maybe you can trust his or her medical opinion that you don't need to see a peri.



My understanding is it automatically considered high risk if they are identical.... my understanding is they think hers are?

 

QUOTE(marisa55 @ May 9 2008, 12:41 PM) [snapback]764597[/snapback]
From what I have been reading, it seems like most of you are seeing a peri. How did you first start to seeing him/her? Did you call on your own or where you refered to one by your OB? Why did you start going? Did your OB set you up with one as soon as you knew you were having twins? Is it considered routine for twin pregnancies to see a peri or did you start going because of complications?

I'm asking because I'm only being seen once a month right now by my OB and I have a u/s once a month also. So, I either seeing the OB and or get an u/s every two weeks. When I asked about seeing a peri or having more frequent u/s, the OB said I did not need either unless complications develop. He did offer for me to just go talk to the peri if I wanted. I think I will at least do that and try to weasel my way into more u/s. I am having mono/di twins, so I'm getting concerned about TTTS, especially because I'm the one with the stupid u/s tech who told me I'm having mono/di twins but she can't be sure they are identical! I really don't know if she knows what she is doing!



I'm in the same boat... trying to get to see one AND convince my Dr. that I need ultrasounds more than once a month in the 2nd trimester with confirmed identical mono/di twins!

If yours are mono/di they are definitely identical. The only confusion is if fraternal twin placentas fuse, but my understanding is this usually looks different on U/S (membrane is thicker)

I hope you don't mind I added you as a friend? trying to cultivate speaking to other people going through same stuff...

 

I have never seen a peri and I have had multiple complications. My doctor seems extremely competent and obviously his course of treatment was effective as I'm over 36 weeks and don't seem to be going anywhere any time soon. I'm having fraternal twins and had PTL and gestational diabetes, plus concerns for IUGR. The babies are totally fine (as far as I know). I have had ultrasounds every 2 weeks for about 2 months now. But never had to see a peri.

 

My ob called the peri and explained my situation (suspected ttts) at 13 weeks. The peri saw me first thing the next morning and at least weekly if not more until 36 weeks. This was as soon as we found out we were having two so I don't know if I'd have been referred if we didn't have ttts.

 

I started seeing a peri around 13wks due to a blood clot. That's when we noticed the my cervix was shorter than it should be. From then until I went on hospital bed rest, I saw either the OB or peri every 2 weeks.

 

QUOTE(aimeethomp @ May 9 2008, 02:02 PM) [snapback]764762[/snapback]
I never saw a peri and I pretty much went full term with my twins. No NICU time or anything like that, I delivered 12 pounds of babies. Just because you are pregnant with twins does not automatically make you high risk. If you trust your OB then maybe you can trust his or her medical opinion that you don't need to see a peri.


I agree with this. My OB delivered my first baby (I delivered at 39w6d - 8lbs 15oz - "easy" delivery) and even though I am in my 30's, I have no other factors to cause concern. Yes, I am overweight, but that doesn't change the fact that I am still fairly healthy. My doc is very interested in making sure her multiple pregnancy patients get great care. She checks heart rates via ultrasound (on an older machine and doesn't charge for it), and checked my cervix via T/V U/S a while back. Like I posted in a PP, starting at 32 weeks, we will see her twice a week to do bio-physical profiles on the twins.

I think that it is a combo of her comfort level in dealing with multiples and her experience of having been PG with twins that perhaps leads her to refer less people to a peri. I don't know - I've never asked. Just assumed. I am totally comfortable with her and I know that if she didn't think she could handle it, she would refer me to a specialist, ya know?

 

QUOTE(desolation_anonymous @ May 9 2008, 04:38 PM) [snapback]764903[/snapback]
I'm in the same boat... trying to get to see one AND convince my Dr. that I need ultrasounds more than once a month in the 2nd trimester with confirmed identical mono/di twins!

If yours are mono/di they are definitely identical. The only confusion is if fraternal twin placentas fuse, but my understanding is this usually looks different on U/S (membrane is thicker)

I hope you don't mind I added you as a friend? trying to cultivate speaking to other people going through same stuff...

I added you as a friend also. Let me know if you are able to convince your OB for more u/s. My twins are mono/di and therefore, identical. Here is were the confusion came in. At the first u/s at 10 weeks the u/s tech said they are mono/di. I had never heard the term and had no idea what it meant. Then at 12 weeks I went to a specialist for the NT u/s and she said they are mono/di and have a very thin membrane (she had a really hard time finding it and had to do an T/V u/s to see it) and she was 100% sure they were identical. Then at the 14 week u/s the tech said you can never be 100% sure until you deliver because the placentas could be fused. I was totally confused. After doing more research and asking the girls on here, I have discovered that if you have mono/di twins they can only be identical. I thought the mono stood for 1 placenta. It actually stands for 1 outer chorionic sack and all fraternal twins have two chorionic sacks. Anyway, sorry about the tangent, just wanted to explain why I was once confused over whether my twins are identical.

 

QUOTE(marisa55 @ May 10 2008, 06:18 PM) [snapback]766475[/snapback]
I added you as a friend also. Let me know if you are able to convince your OB for more u/s. My twins are mono/di and therefore, identical. Here is were the confusion came in. At the first u/s at 10 weeks the u/s tech said they are mono/di. I had never heard the term and had no idea what it meant. Then at 12 weeks I went to a specialist for the NT u/s and she said they are mono/di and have a very thin membrane (she had a really hard time finding it and had to do an T/V u/s to see it) and she was 100% sure they were identical. Then at the 14 week u/s the tech said you can never be 100% sure until you deliver because the placentas could be fused. I was totally confused. After doing more research and asking the girls on here, I have discovered that if you have mono/di twins they can only be identical. I thought the mono stood for 1 placenta. It actually stands for 1 outer chorionic sack and all fraternal twins have two chorionic sacks. Anyway, sorry about the tangent, just wanted to explain why I was once confused over whether my twins are identical.



It was confusing to me also at first because so many people told me that the mono meant they shared a placenta. I had to research to figure out that the mono stood for the chorionic sac not the shared placenta (which mine do share one). And the earlier the u/s the less likely they are to confuse mo/di twins with di/di twins having a fused placenta. At 11 weeks (when we found out we were having twins) the tech said (mo/di).. then again at 15 weeks.. I see the same tech every time and she has written right smack on the top of her files.. "MONO/DI". That being said.. Mo/di twins are high risk.. automatically. though I think most OB's consider twins of any kind to be high risk.. mo/di or mo/mo twins have an increased risk.

I was totally comfortable with not seeing a Peri until after my 24 weeks u/s that showed one of my girls measuring behind by a weeks difference when they were within 2 days difference up until that point. Had my girls measured within the same range I probably never would have questioned seeing a Peri...heck.. I didn't even like the idea of having to see an OB along with my MW.. I am so comfy with my MW's care that I would have preferred just stick with her.. Go with what you feel is right for you and your babies.

 

We actually started seeing one pretty early on because our first child was born with a rare genetic disease. We saw them before we even knew we were having twins (we didn't find out until 20 or so weeks at our ultra sound). We met with a geneticist, etc. Our ob referred us to one.

 

My OB said she didn't think I needed to see a peri regularly, though she offered to refer me to one if I wanted. But she did want me to go to a peri for the 12-week quad screen and nuchal fold measurement, and again for the 20-week ultrasound. That was enough for me, but it did make me feel better to know that she had a peri she worked with regularly, who we could see more often if the need arose. I also had a lot of confidence in my OB to notice any complications in time (and I wasn't at great risk for them since my twins were fraternal).

My OB did do u/s at 8 and 10 weeks (though I think she only did the 10-week one because she couldn't get the heartbeats on the doppler). Then I don't think I had one between 12 weeks (with the peri, for the nuchal) and 20 weeks. Then I didn't have another one until I was in the hospital at 29 weeks for threatened PTL, and then another one at 36 weeks just before I delivered.

 

As soon as we found out we were having twins (at 8 weeks) we were refered by our OB.
I think in there office its just normal for any multipuls to go to a peri also.