Mono/Di Delivery

My OB has said from the beginning that I would have a C-section with my mono/di twins. Now that they have seen the very thin membrane and are certain they are not momos, they have given me a deadline of 34 weeks to deliver my twins. Is there anyone out there who can share their experience delivering this early and is it possible to induce and have a vaginal delivery or am I destined for a c-section?

 

I had my mo/di twins at 38w4d. I had to have a c-section because they were both breech and had been for quite a while. If both babies had been vertex my peri may have let me go vaginally. As it was I was kind of relieved to have the decision out of my hands - we had TTTS, and although it was stable, I was still pretty scared, and was totally ok with a c-section. We were monitored evry frequently at the end, but we hung in there! Mine were still small, but mostly healthy!

jenny

 

I am also pregnant with mono/di twins and my OB will allow me to attempt a vaginal even if baby A is vertex and baby B is breech since I have had 2 previous vaginal deliveries. My c-section is scheduled for 38 weeks (although she doesn't think I will last that long), and won't be planned any earlier unless there is a medical need. I have heard many different things on the website and it seems that all docs have their own opinions etc. I found it to be a bit stressful as well thinking who I should listen to. I decided just to trust my Ob unless I start feeling uncomfortable with her decisions. I am also consulting with Dr. DeLia (I have no sign of TTTS) about the delivery at 32 weeks and he said he will share his views with me based on my situation then. I will post and let you know what he recommends since he is the expert. Try not to worry about it, you have plenty of time to research-Good luck

 

I am 33 W 4 D pregnant with mono/di twin girls. We had laser surgery for TTTS at 24 weeks. Since 28 weeks we have had ups and downs with Baby A's fluid level, growth etc but the doctors insist they are still better off where they are in utero than out. My doctors have always said delivery will be between 36 and 37 weeks if I don't go sooner on my own and they will deliver vaginally (I will be induced) if Baby A is head down. They told me there is absolutely no reason I would NEED a c-section if at least Baby A and hopefully Baby B is head down. My delivery will be handled by my peris at the high risk hospital but if it were at our regular hospital with just my OB he would have delivered them vaginally as well. Basically my doctors have all explained to me that it boils down to babies position, and the doctors comfort/experience level with delivering twins, and of course a non-emergency situation.

That all being said I am in hospital now as my babies tried to come 5 days ago. We were going ahead with a vaginal delivery and I got to 4cm dialated and everything stopped!! The doctors will let them come if my body progresses on its own otherwise they would rather they stay put until at least 35 - 36 weeks.

I am curious as to why your doc wants them out at 34 weeks when everything is fine?

 

At 13 weeks, why does your OB give you a dealine of 34 weeks???? That's early. It's best to keep those babies cooking as long as possible. A few weeks makes a big difference. A few DAYS makes a big difference. I had mono-di twins with a very thin membrane as well. I carried until 37 weeks and was induced due to pre-e. Delivered both vaginally (both were head down). Is there a good medical reason for delivering that early? I don't know how well inducing will work that early as it is likely your body is not ready for delivery.

 

QUOTE(MusicalAli @ Jul 27 2008, 12:18 PM) [snapback]898772[/snapback]
At 13 weeks, why does your OB give you a dealine of 34 weeks???? That's early. It's best to keep those babies cooking as long as possible. A few weeks makes a big difference. A few DAYS makes a big difference. I had mono-di twins with a very thin membrane as well. I carried until 37 weeks and was induced due to pre-e. Delivered both vaginally (both were head down). Is there a good medical reason for delivering that early? I don't know how well inducing will work that early as it is likely your body is not ready for delivery.



I have noticed that the "very thin membrane" has been mentioned several times. My membrane is very thin and we often had trouble visualizing it at first. Why is this important or does it make a difference? I am just curious as people have referred to our membrane this way numerous times but I have never thought to ask. Thanks.

 

When doing u/s with the peri, she always makes it sound like the babies will come at 38weeks...she says 38weeks is term for twins. I have mono/di twin boys...very thin membrane and at 21weeks they are measuring practically the same (baby a @15 oz and baby b @ 1lb) I'm monitored with a peri every 3 weeks and haven't been given any indication that b/c the babies are mono/di that I'd have an early delivery or that it's necessary. I guess I would be very concerned if my drs were suggesting early delivery without some indication of a problem. NICU sounds so scary to me...

 

QUOTE(MusicalAli @ Jul 27 2008, 12:18 PM) [snapback]898772[/snapback]
At 13 weeks, why does your OB give you a dealine of 34 weeks???? That's early. It's best to keep those babies cooking as long as possible. A few weeks makes a big difference. A few DAYS makes a big difference. I had mono-di twins with a very thin membrane as well. I carried until 37 weeks and was induced due to pre-e. Delivered both vaginally (both were head down). Is there a good medical reason for delivering that early? I don't know how well inducing will work that early as it is likely your body is not ready for delivery.


My peri's explination for the 34 week delivery is that "they" have seen an increased and unexplained sudden loss of one twin once you get past 34 weeks which (because they are mon/di) will severly injur the other twin. I've not done any research of my own about this phenomenon, as I'm trying to stay off the scary websites, so I thougth I'd ask about it here. It's encouraging to hear of so many who have gone past 34 weeks and I'll definitely be talking with my ob and peri about the timeline.

Thanks for all of the responses!

 

QUOTE(TwinsInFL @ Jul 28 2008, 05:04 AM) [snapback]899567[/snapback]
My peri's explination for the 34 week delivery is that "they" have seen an increased and unexplained sudden loss of one twin once you get past 34 weeks which (because they are mon/di) will severly injur the other twin. I've not done any research of my own about this phenomenon, as I'm trying to stay off the scary websites, so I thougth I'd ask about it here. It's encouraging to hear of so many who have gone past 34 weeks and I'll definitely be talking with my ob and peri about the timeline.

Thanks for all of the responses!


Yes, I'm glad you will be talking to them. In all my research and all my time talking with other mom's of twins, I've never heard this rationale for delivery at 34 weeks. Sounds like they are misinformed, which would be shocking for medical professionals, though not unheard of. If anything, I've heard maybe past 39 weeks as the placenta can start to not function well. That being said, I hope you carry until at least 38 weeks and give birth to big and healthy babies!!!

 

wow! i have mono di girls who are almost 8mos now. i was seen at a multiples clinic and their deadlines were 36wks for one placenta 38 weeks for two. my doc was awesome! the philosophy of the practice was as long as baby a was bigger and head down they would do vaginal. that was my situation - a- was head down and bigger, b- was breech and a bit smaller. my water broke at 35.1 and they offered me a c/s when i arrived at the hospital but i turned it down since my doc and i had spoken about it and she felt a vag delivery would be fine - they really try to avoid c/s there. i wasnt really contracting with any regularity so i got my epidural put it - just to be ready - and let them induce me. it was a long induction but when it was time to push, baby a came out after like 30 min of pushing and b followed 5 min later - butt first! but it really depends on your hospital - i know a number of women who delivered their twins at another hospital in the area and they all had c/s - i mentioned this to my doctor at my 6wk follow up and she was like "oh yeah that hospital does a c/s for the littlest thing." so, its part up to you and part up to your doc, but i would really question 34wks - unless you have other issues like ttts, pre-e, or iugr - b/c the lungs may not be mature, you will most likely have nicu time (which isnt necessarily a bad thing) and it just seems unnecessarily early. what ever you decide - good luck! what is most important is a happy mom and healthy babies.