Mono/di twins with discrepancy in NT scan and size

Hey guys!

Wondering if anyone had similar results at their NTS, and if so, how did things progress? I've got mono/di ID twins and I had my nuchal scan at 12.5 weeks. One fetus measured high on the nuchal (over 4) and the other was normal (about 2). And baby B is about a week behind in growth.

I'm still more than a week away from my follow-up u/s to test for TTTS, two weeks from potential amnio (though haven't decided yet whether to do it), and it's really getting to me!!!

Has anyone had similar results? What was the outcome? Did things correct themselves? TTTS? Did you do an amnio? Would love to hear from anyone who's been through this stressful time... the waiting is really tough!

 

Hi Hrm, I am currently 18 weeks w/ mono/di twins also. I have not yet been diagnosed with TTTS but am concerned about it. You can find a ton of info on this website: http://www.tttsfoundation.org/index.html I suggest checking it out. Your Dr. should be checking up on you every 2 weeks. I would not suggest an amnio as it can cause a miscarriage and the results are not as accurate with twins. My husband and I decided right from the beginning not to have one. Just take it easy and start drinking some high protein drinks such as Boost or Ensure, if you can.

Even though I haven't been diagnosed with TTTS doesn't mean it can't happen. It can happen at any point during the pregnancy. Some of the stories on the TTTS foundation website will prove this. I am currently dealing with one twin being smaller than the other due to umbilical cord placement. It isn't that bad right now but am being watched carefully by a perinatal Dr. for any complications. TTTS can overcome it's self with proper bed rest and high protein drinks and worst case some surgical procedures. With one baby being a week behind in growth you should ask about seeing a perinatal Dr. since they can do better testing for TTTS and other complications with mono/di twins.

I wish you the best of luck and if you have any questions, don't hesitate to ask.

 

Hi - I'm in a very similar situation and so far everything is fine. I am now 26 weeks with mono/di ID twin boys. When we went for my NT/first trimester screening, twin A had a NT measurement at the higher end of normal (2.7 or 2.8 I think) and twin B had a normal measurement. Twin A was also measuring several days behind twin B. My bloodwork also came back abnormal and we were given a risk of Down's at 1 in 28. I was referred to the perinatologist right at 16 weeks. On his ultrasound there were no soft markers for any genetic abnormalities, but we decided to proceed with the amniocentesis because my husband and I really needed some definitive information about the boys - it was too hard for us to only have risks and odds to think about. Anyway, the amnios came back normal for both boys (and amniocentesis is as accurate for twins as it is for singletons). At that visit, however, the size discrepancy had increased to about 10 days difference and the perinatologist gave us about a 50/50 chance of developing TTTS. I did as much reading as possible on websites like tttsfoundation, fetalhope, and askanob and started myself on protein supplements - I use the Myoplex drinks or make my own whey smoothies because they have much more protein and fewer carbs than the Boost shakes. We also began weekly ultrasounds to monitor the growth of the twins. So far, the growth difference has remained constant and twin A continues to grow appropriately week to week. We consistently measure about 20% difference in their weights, but my doctors have told me that as long as they keep growing and the difference remains constant, then we should not worry about the different sizes. For the first time at our last ultrasound, our perinatologist said that he now doesn't believe we have TTTS.

So, just because you have size differences in your twins and a higher NT in one, that does not necessarily mean that anything is wrong at all!

Hope our experience helps you see that there may not be anything to worry about! Good luck with everything.

 

Thanks houstontwins and lex1078! It's so nice to know that I'm not alone here.

I know that the risk of TTTS can continue throughout the pregnancy, but I wasn't expecting to worry about it this early!

I'm on prenatals along with additional folic acid, iron, and calcium supplements but my Dr. (also a perinatologist) didn't mention anything about protein shakes - is that commonly recommended for TTTS? I'd thought the protein shakes were just for if you weren't gaining enough weight. I've been lucky and haven't had any morning sickness at all, so I think I've been getting good nutrition. Anyway I'll pick up some Boost at the grocery store - I guess it can't hurt!

 

Wish I could help, but I wanted to let you know the correct information on what was given....

Amnios are NOT less accurate with twins, it is the bloodwork that is often done along with nuchal screening (I think it is called a triple screen?) that is less accurate. Amnios are the most accurate genetic tests you can have, and it does not matter if they are a singleton are twins. (but of course, there are always thinks like a small number some cases of children being genetically downs, etc. who don't have any symptoms of the syndrome when they are born- it doesn't mean their chromosones aren't indicative downs, just that the syndrome didn't affect them.)

I just wanted to point this out so you have full information in making any decisions...

As far as you deciding to have an amnio, I think it depends on if you would do things differently based on the results or not, and/or if you need to know to prepare yourself for any potential problems. There are risks for everything, but still the risks are very, very small. The risks at my facility was 1/400 would have problems after (including ALL potential problems), and it was pointed out to me that anyone who had problems within two weeks of the amnio was counted in this number- so the number might have been smaller as there were bound to be problems for some anyway/just coincided with dates. If the risk is concerning to you I'd suggest talking to a genetics counselor and finding out the risks for your facility. I wish you the best in discussing this with people it involves and coming to a decision that is right and works for you. I believe this is an individual decision and should be decided by you and your family on what is right for you, not what others believe is right based on their personal beliefs, etc. I urge you to get the accurate risk info from your doctor, as you may be unecessarily worried/scared or put at ease by others' input.

I DO remember someone posting somethign similar- you may want to PM her to find out what happened.... I think this is the post http://www.twinstuff.com/forum/index.php?s...3&hl=nuchal

 

I'm 23 weeks with mono/di girls and we did the triple screen which came back fine, but pp is correct...the amnio would be much more accurate should the blood work prove inconclusive. We are facing a similar situation with our second trimester blood work showing our girls were at risk for spina bifida. After a closer look on the u/s they see no gaps in either of their spines, but the only way to be certain would be to conduct an amnio on each of them. We have elected not to do this, because it wouldn't make a difference for us. Just know that, in general, blood tests results are more accurate for singletons and this community is full of ladies who have gotten "bad news" as results of these tests that turned out to be completely false.

Follow the advice of your peri and don't stress out if they're not worried. My goal is to avoid an amnio at all costs as they can lead to miscarriage. I'm not going to freak out unless my peri does (and he's paid not too :rofl: ).

 

My ID girls had TTTS. They are almost 7 years old but it feels like yesterday that I was praying they would survive the diagnosis. I had 3 amniotic fluid drains, a total of 9 lbs were drained. I managed to deliver them vaginally at 35 weeks after 8 weeks of bedrest, 4 of those in the hospital. Email me any time with questions [email protected].