mono/di twins

I had an ultrasound yesterday and it appears that the babies are sharing one placenta but both within their own amniotic sacs which I understand is called monochorianic/diamniotic. Both babies are measuring equally, 19 weeks and 2 days and 10 oz. each, which is right on target as I will be 19 weeks tomorrow. Oh..they are also two boys and I guess likely identical given that they are mono/di! :itwins_boys:

I'm just curious if anyone else has had any experience with mono/di twins? I know that they are at greater risk for TTTS but just wondering if there is anything else unique about this type of twins. Any good resources for learning more?

My OB said that I would have another ultrasound about 26 weeks and then I would receive them every 3-4 weeks until delivery. Does that sound about right?

Thanks!

 

I think I had more u/s than that with frat twins... I think it all depends on how you are doing and how your babies look...any concerns will result in more frequent u/s... But I wanted to chime in that although I haven't had mono-di twins, I am almost positive that my id. twin sister and I were mono-mono twins...according to my mom's memory we shared a placenta and a sack... but the doctors were unaware that we were twins until the birth...so what could have been catastrophic turned out just fine. So regardless of all the monitoring and scary stories, sometimes these situations can progress without a single hitch.... Hope you have an enjoyable, non-eventful remaining pg...

 

I don't have much experiance yet -- I'm currently just over 17 weeks with mono/di boys -- as far a monitoring, i know it is very variable. I am seeing an OB and a peri as well (I also have high blood pressure) -- but I know that my Peri is doing ultrasounds every 2 weeks from 16 weeks on to check for TTTS -- as well as cervical length. On top of that, my OB has an agressive schedual for twin moms in general, and as of 20 weeks I'll be seeing him every 2 weeks as well. He also does an ultrasound at every visit but mainly because he likes the extra resasuance of an ultrasound heart check since he doesn't feel completly comforatble with getting both heartbeats on dopler. So, given all that, since i'm stagering apointments, i'll be getting an ultrasound every week from 20 weeks on. Now, some of this may also have to do with the high BP. I'm on medication that has been shown to sometimes cause IUGR -- which I know they are looking out for as well.

I'm not sure if any of that helped you -- i know it is very dependent on the individual doctor. I seem to be going to a VERY cautious practice - but i know several expectant mom's who's OB sounds more like yours. I think what really matters is if YOU feel comfortable with the schedual that your doctor has sent up for you. Congratulations on your boys!!!

 

Congratulations on your little boys! I am also carrying mono/di boys. If there is truly only one placenta and not two that fused then they are identical meaning that one egg split. They will have the same blood type and DNA. Yes there is a risk of TTTS but that's why they will be monitoring you very closely. Up until I was about 26 weeks I was having u/s by a perinatologist every two weeks to make sure that there wasn't any kind of growth discordance. After that it has been more like every 3 weeks because I have not had any problems at all. Just make sure that you feel comfortable with the ammount of care you are recieving because mono/di twins definitely need to be watched closely. Also make sure that whoever your doctor is not only has a lot of experience with twin pregnancies but also with TTTS. They need to make you aware of the warning signs. Just try and relax, there are several of us on here carrying mono/di twins and our pregnancies are going very well with very few problems.

 

Welcome! My dd had mo/di twins 4 1/2 months ago and she was seen every two weeks by the MFM and then the opposite two weeks by her ob... it was very comforting for her to be seen so often. She had a very uneventul pregnancy (except gestational diabetes which she controlled with diet) and carried the boys to 36w 1d. She had a scheduled c-section and the boys went home with her...
Lindy,
Mom to Stephanie and Nana to
Cameron and Corey
Born 11-29-06

 

Thanks for the words of advice and support. For those of you also seeing a Peri, did your OB recommend the Peri or was this something that you opted to do? I am right now just seeing an OB but wonder if seeing a Peri is important at this point. I did question my OB early on in my pregnancy about seeing a Peri but at the time it seemed like the only reason I would do that would be if I was interested in having further testing such as an amniocentesis. Any thoughts?

Thanks

 

I have mono-di twins but all during the pregnancy the OB thought they were di di with a fused placenta--turns out he was wrong. I did not see a peri because there is no peri anywhere near where I live, but I did choose my OB based on the fact he had the most experience with all kinds of high risk pregnancies-mulitples espcially in my town. He also has one of the best ultrasound machines in town right in his office so I had an u/s at every appointment. There is a risk of TTTS but try not to get to worried about it, especially since they are measuring the same at the moment. You should have a high resolution ultrasound so they can see the vesels in the cords and to make sure that both have the correct number of vesels in the cord (experts, did I get that right?).
Again, I know it's hard not to stress about what could go wrong, but try to stay relaxed and positive-that will help you and the babies have a good pregnancy!
Congratulations on twins!

 

I am pregnant with mo/di twins right now. I have ultrasounds every two weeks since about 14 weeks. I also have cervical lengths done as well. But I think it is all dependent your doctor practices. Good Luck and feel free to PM with any questions.

 

Congratulations!! You definitely should be having ultrasounds at least every two weeks at this point. If I were you, I would push for this...and if your OB disagrees then find someone else. Sounds like your boys are doing great so far, but it's important to stay "on top of things." A lot of OBs don't send you to a peri unless there's something wrong, but make sure your OB has lots of experience with mono/di twins, in particular. A peri is more experienced in being a doctor FOR THE BABIES. We chose to see a peri as well as our OB because we had previously lost twins to TTTS. We were with a different OB at the time and he ended up being very inexperienced with looking out for signs of TTTS...until it was way too late. It's great that you've gotten to almost 20 weeks with no problems! Make sure you're getting enough protein and rest. Be informed about TTTS, etc., but don't let it overwhelm you either.

 

i am pregnant with mono/di boys - my ob does u/s every 4 weeks to check for growth and cervical length

i keep asking lots of questions at the ob...

 

Most of the info has already been covered here, but just for your peace of mind, if you are at 19 weeks with no problems or growth discordance you are pretty much in the clear for severe TTTS. I saw a MFM at 20 weeks for a targeted u/s; she spotted no problems and did not recommend my seeing her again unless my OB spotted a problem. She recommended u/s every 3 weeks with my OB.

Of course, educate yourself, but try not to freak out. Lots of us on the board are carrying mono/di with no problems.

Take care of yourself and your babies!
Jen

 

Congrats! I gave birth to mono/di twins almost a yr ago. I had a very easy pregnancy and gave birth at 39 weeks and 1 day. If my blood pressure didn't rise I would of went longer, I ended up with a emergency c-section. I was monitored via u/s every 3-4 weeks until I gave birth, I also had a small u/s at every doc appt to find the heart beats. I was very lucky to not have had TTTS. TTTS is very rare and the odds are that all you ladies will have healthy pregnancies without TTTS. If you all have questions and want to know more about it here is a website that has a lot of info. Good luck and I wist you all a happy and healthy nine months.

 

yup my wife is now 5 months preggy w/ boys. ammnio and everything are look good. our GYN dr still want us visit special dr to keep eyes close on my wife and make a plans just in case soemthing pop up.
they re about a week apart. so Dr is a bit concern about that. We re seeing Dr every 2 weeks.

Hang in there.

Jake

 

I am not too experienced. I'm only 25 weeks with mono/di twins. I had 2 U/S till now. One when I was 18 weeks (that was an emergency U/S due to high AFP readings...and voila...we found we are having twin boys!!!) and another regular one when I was 21 weeks. My 3rd U/S would be when I'll be 26-27 weeks. So, I guess only after 28 weeks, they'll send me for bi-monthly U/S (or atleast that's what I am thinking).

As far as my OB visits go, I've been meeting them once a month till now. It'll be twice a month starting next month.

 

Like Melissa said, you should get u/s every 2 weeks with mono/di twins. Bascially, the only thing you have to watch out for TTTS but TTTS can happen suddenly and needs to be treated quickly. Those of use who had successful TTTS pregnancies were blessed with doctors who watched us closely and recognized the signs right away. You have about a 90% chance of not dealing with TTTS but it's something that needs to be watched for because it can usually be treated. If your OB has experience with mono/di twins, you should be fine without a peri for now. Not all twin pregnancies require a specialist it's just that mono/di and momo pregnancies are especially high risk. Definitely get your protein and water!

 

This is long, and please, I don't want to scare you!

I am pregnant with mono/di boys, and we are Stage I TTTS. We've been at Stage I since 21 weeks. I can share more info about my situation if you are interested, but I just wanted to say that TTTS varies in severity and progression.

You are in a great spot at 19 weeks! By 19 weeks, many people with TTTS have already noticed growth discordance (which you do not have), variance in amnio fluid levels in the sacs that may or may not be out of normal range (3 to 8 cm being normal range), and various other indicators (no bladder visible in donor baby, etc.) SO please do not worry, it sounds like you are doing great.

But I would recommend that you push your doc for more ultrasounds to keep monitoring you and your precious boys. TTTS can flare up at any point, including at the very end or during delivery of what seemed like a very healthy mono/di pregnancy. Acute TTTS can occur, and your docs just need to keep a watch out for it to be on the safe side. This isn't meant to scare anyone, but understanding and being away of TTTS and its symptoms will give you reassurance when you are doing well and will also help you be prepared if anything should start to look amiss.

TTTS occurs in an estimated 1/3 of pregnancies where the placenta is shared. It is "rare", but it is not as rare as you think. Because it scares us, we don't want to know anything about it ("ignorance is bliss"), and many OBs are reluctant to tell their patients about TTTS because they don't want to scare them. Or they simply do not understand this very complicated syndrome themselves. If OBs don't pay attention and educate their patients in a timely and caring manner, in many cases, patients don't think they have any choices for hope for their babies. . . and it can be too late. TTTS is one of the biggest, if not the biggest challenge, facing obstetrics today. Just today, our experienced fetal cardiologist told us that the syndrome is not completely understood and it's very complicated.

I think your pregnancy and babies will be just fine, but I hope that all parents of identicals, in utero or out, will not ignore helping to educate others about the disease. Please educate yourself and demand more for your mono/di pregnancy care. I think between 16 and 26 weeks is VERY crucial for keeping an eye for TTTS. At 26 weeks, it's my understanding that the laser surgery option becomes null and not an option. Mid-pregnancy is a crucial time. Know what the other indicators for TTTS are instead of just focusing on the growth discordance/measurement.

You might contact the TTTS Foundation (Mary, founder of the foundation, is very helpful and compassionate), and might give you a recommendation about how many u/s you should ask for even if you are having a very healthy mono/di pregnancy. www.tttsfoundation.org

Unfortunately, no mono/di twin pregnancy is ever completely out of the clear (it can happen unexpectedly and tragically at labor/delivery - this is why many docs will only do a c-section on mono/di twins instead of vaginal). So please, don't be scared! Just be educated. I highly recommend reading the info at the Foundation's website. Your doctor may not understand or have attempted to understand TTTS, so please check it out!

I wish you an awesome, healthy pregnancy!

 

QUOTE(happyfor2 @ Apr 18 2007, 01:28 PM) [snapback]225472[/snapback]
I had an ultrasound yesterday and it appears that the babies are sharing one placenta but both within their own amniotic sacs which I understand is called monochorianic/diamniotic. Both babies are measuring equally, 19 weeks and 2 days and 10 oz. each, which is right on target as I will be 19 weeks tomorrow. Oh..they are also two boys and I guess likely identical given that they are mono/di! :itwins_boys:

I'm just curious if anyone else has had any experience with mono/di twins? I know that they are at greater risk for TTTS but just wondering if there is anything else unique about this type of twins. Any good resources for learning more?

My OB said that I would have another ultrasound about 26 weeks and then I would receive them every 3-4 weeks until delivery. Does that sound about right?

Thanks!


I have mo/di girls that are 9 months old. I lived in constant fear of TTTS, but it never happened! And the odds are that it won't! Mo/di are the most common form of identical twinning. Mo/mo are rare and dangerous and di/di are rare but CAN happen (I think if the egg splits within the first 12-14 days of conception).

I don't really remember how many US I had but it felt like once a week I think I had once a month from 18-24 weeks then bi-monthly 25-32 weeks. Then at 32 weeks I had weekly Non-Stress Tests. If I failed the NST (which we did, twice) then they would send me for a BPP (Biophysical Profile). You should have more US with mo/di than with di/di since you will have to have the fluid checks and growth checks ... to make sure you aren't having TTTS. I think once you pass ... hmmmm ... I think it was 28 weeks, your odds of having TTTS go down ... I think ... I wish I could remember more! Man, the babies living on the outside world can really sap your brain I had them at 34 1/2 weeks b/c of pre-e.

Good luck and don't worry! (I know, I know easier said than done)!!

Traci

 

My mo/di twins had TTTS. They measured a week different at 16 weeks, and two weeks later, my smaller baby had NO fluid. We were monitored weekly - I was put on bedrest for 21 weeks, and delivered at 38w4d!

TTTS is not as rare as you think, but has varying degrees. And, I wanted to add that just because babies are the same size does not necessarily put you in the clear. What is more important is fluid levels, dopplers, visible bladders. Growth discordance is often the result of those things. I would encourage you to see a peri for at least one more u/s between now and 26 weeks, like PP said, that is a crucial time.

I don't mean to scare you, but there is NO safe "week" for TTTS - it can appear at any time - all the way up until delivery. After 28 weeks, the babies are more likely to make it, though!

I am here to help if you need it!

jenny

 

I clicked on this thread and started browsing through the responses...and then I saw mine, and I thought "I don't remember responding to this!" So I looked and it's from a year ago.

I don't think any more replies are needed.

Oh, and the OP's boys are now 8 months old.