Mono or Di chorionic?

I am a bit curious as to what others experiences have been with this.
At my first ultrasound at 9 weeks the tech said she was pretty sure the babies were in their own sacs. She showed us some little "knob" and said, "this looks good b/c it means most likely they will have two placentas." The babies were measuring: Baby A: 9wks exactly Baby B:8w6d

Yesterday, different tech and not nearly as informative (I had to ask her EVERYTHING I wanted to know), stated she couldn't for sure find a seperating membrane and said she only saw one placenta but it could be two fused together. She also stated that one baby was 2 days behind the other but couldn't remember which one. (I had to ask all my questions after she was done with the scans b/c I kept thinking she was going to turn the screen for me to see and start telling me everything like the other tech did but it never happened)

Isn't there a "sign" they can see that supports if it is one or two fused? Does the 2 day lag in one baby's development automatically mean TTTS? Shouldn't she have measured amniotic fluid and wouldn't that have shown if they were in two sacs? Or am I just being overly nervous and this is stuff the doctor will be able to go over with me at the appointment and the tech was basically just the picture taker?

TIA!!!
Jenn

Here is a link to the first u/s pics at 9 weeks

http://i53.photobucket.com/albums/g59/j_j0...ncy/Image15.jpg
http://i53.photobucket.com/albums/g59/j_j0...ncy/Image16.jpg
http://i53.photobucket.com/albums/g59/j_j0...ncy/Image17.jpg
http://i53.photobucket.com/albums/g59/j_j0...ncy/Image21.jpg
http://i53.photobucket.com/albums/g59/j_j0...ncy/Image22.jpg
http://i53.photobucket.com/albums/g59/j_j0...ncy/Image23.jpg
http://i53.photobucket.com/albums/g59/j_j0...ncy/Image20.jpg

 

i wanted to share my u/s picture with you from 7w4d with you. It looked simlar to yours.
http://i150.photobucket.com/albums/s99/sisrea/IMG_1275.jpg

Mine are mono/di. They sent me for a lvl 2 u/s at nearly 12w with a peri that was able to tell the mono/di. As the pregnancy progress the membrane between them can become easier to distinguish.. It was hard to get at my 1st u/s but eaiser to find next time. As far as the date difference. mine were the same. For TTTS, I think they really start looking for it at 15-16 weeks.. I don't think it is an issue before then because the placenta isn't even doing all the work yet or fully developed. When they start looking for the TTTS they will look for cord flow, and how much fluid the babies have and if they are measuring within 20% of each other.. I know there is more things that they will look for later on like bladder and kindney function, i think...

But so far it sounds like they are looking good! Yay!!!

 

QUOTE(Sisrea @ Jan 9 2009, 12:03 PM) [snapback]1139808[/snapback]
i wanted to share my u/s picture with you from 7w4d with you. It looked simlar to yours.
http://i150.photobucket.com/albums/s99/sisrea/IMG_1275.jpg

Mine are mono/di. They sent me for a lvl 2 u/s at nearly 12w with a peri that was able to tell the mono/di. As the pregnancy progress the membrane between them can become easier to distinguish.. It was hard to get at my 1st u/s but eaiser to find next time. As far as the date difference. mine were the same. For TTTS, I think they really start looking for it at 15-16 weeks.. I don't think it is an issue before then because the placenta isn't even doing all the work yet or fully developed. When they start looking for the TTTS they will look for cord flow, and how much fluid the babies have and if they are measuring within 20% of each other.. I know there is more things that they will look for later on like bladder and kindney function, i think...

But so far it sounds like they are looking good! Yay!!!


Thank you so much for your response. I see you are 33 weeks along! Great job keeping them in there and you are so close to the end, good luck with everything! You have calmed my fears a bit and I am grateful for that. So, your little ones have shown no signs of TTTS?

 

They say that after about 30 weeks ?? i think.. it is rare to deveolope TTTS. Mine have alwasy been good very close to each other..... They are starting to watch baby A, She has gone from 10-14% difference, but is still normal and cord flow is very good.. I have been very very very glad that they have done so well with no complications..

 

They said my boys were mono/di my whole pregnancy and my baby A was 2 weeks behind baby B the whole time as well. They thought the boys had TTTS. We just got the report back and it was actually 2 fused placentas. So I'm not sure if there is anyway to tell through ultrasound if it is one or two fused.

 

We have a very similar situation. Our techs in the beginning were not very helpful so they could never say for sure whether the twins were monozygotic or dizygotic but our first u/s photos looked a lot like yours. They sure looked to be in the same outer sac - when I see other dizygotic u/s photos there are clearly two black gestational sacs and in our case (and yours) it looks like just one.

Just now at 18 weeks my doctor is finally starting to commit to them being monozygotic. I have a complete placenta previa but again, since it's so late in the pregnancy now it's difficult to tell for sure whether it's just one placenta or two that have fused. I have a level II u/s next week with a peri (my first peri appointment) so hopefully they can shed some light.

One baby has always measured 3-5 days smaller but they haven't checked growth for a month so I'm not sure what the TTTS concerns are right now. I guess I'll find out next Friday!

Good luck, they look monozygotic to me!

 

11 weeks to 14 weeks is the best time to see if there is one or two because they have rarely fused together yet (so I've read, I'm not a doctor). Also to me it looks they are in the same sac (can't tell if there is a separeting membrane or not) which would probably mean they only have one placenta. They had to search for my separting membrane at each ultrsound and if you don't have a good tech they might not find it. One was about to give up and put that their wasn't one when he did one last scan to show positioning and it just popped out. Also they are only techs and some won't tell you anything. They take their pictures to the radioligist to go over and they give their report and then send it to your doctor. I asked the tech at my 12 week ultrasound how many placentas there were and she said she thought only one. But in the report it says there is only one. It has more detailed information than the lady would give me at the time. They are trained to see stuff but not diagonis (sp?). Talk to your doctor about the report or if your really worried and don't want to wait you can call the place you had it done and they should be able to tell you. My doctor hadn't recieved the report when I went and so I called the place and they told me the results over the phone. Good luck to hoping they find the membrane. I would deffinatly ask the doctor to do another scan to look for it because that is a big big difference if their isn't one.
This is all my understanding of it all (my husband tells me I read the internet too much but I've learned that all doctors don't always know as much as they like to make you think they do. They might sound well informed about twins and then not know to look for TTTS.)

 

Go see a perinatologist or maternal fetal medicine specialist who specializes in 1st trimester ultrasounds. Don't wait too long because my MFM told me it is easier to tell the earlier it is (if there is one placenta or two). I also remember him talking about a "twin peak" but I can't remember what he was talking about. Anyway, at my 11.5 week u/s the tech found twins but couldn't tell faternal or id. She got the MFM who properly diagnosed me with mono/di twins. He is a specialist and he even had a hard time finding the dividing membrane. He said it was very thin. My experience with the techs were different...some where good, some were not so good. I think the good ones just had more experience. But u/s techs, unlike the dr, can't diagnose, so they tend to not say much especially if you are high risk. Luckily my MFM came right in after every u/s, so I just saved the questions for him.

 

QUOTE(beckylynn @ Jan 9 2009, 12:36 PM) [snapback]1139845[/snapback]
We have a very similar situation. Our techs in the beginning were not very helpful so they could never say for sure whether the twins were monozygotic or dizygotic but our first u/s photos looked a lot like yours. They sure looked to be in the same outer sac - when I see other dizygotic u/s photos there are clearly two black gestational sacs and in our case (and yours) it looks like just one.

Just now at 18 weeks my doctor is finally starting to commit to them being monozygotic. I have a complete placenta previa but again, since it's so late in the pregnancy now it's difficult to tell for sure whether it's just one placenta or two that have fused. I have a level II u/s next week with a peri (my first peri appointment) so hopefully they can shed some light.

One baby has always measured 3-5 days smaller but they haven't checked growth for a month so I'm not sure what the TTTS concerns are right now. I guess I'll find out next Friday!

Good luck, they look monozygotic to me!


I have thought the same thing when looking at other ppl's u/s. I thought, man they clearly have two completely seperate sacs, mine just have this little thin (or at least clearly did at the 9 wk u/s & I am pretty sure I saw it at this one) bubble around each one. But having the membrane means diamniotic so we don't have to worry about cord entanglement, right?

 

We found out at a 15W u/s that they are mono/di, and even now at 23W the tech has to search to find the seperating membrane because it's so thin. But it IS there, thank goodness. They were concerned about them developing TTTS, and baby B has been a bit behind his brother in weight and size for a few weeks now, but thier fluid is still equal. They finally decided it's not TTTS, but a growth restriction caused by an arterial restriction in B's cord. Thankfully his heart is structurally sound and his brain bloodflow is still very good. i worry enough about them as it is, being in thier own sacs, i cant imagine how freaked out i'd be to not know at all.


23W6D mono/di boys

 

No one wanted to commit to saying ours are mono/di until I had an u/s with the genetics department (about 30 weeks) and they said it looks like they are mono/di. I didn't find out until I was in preterm labor (at 33 weeks) that my 12 week u/s report stated mono/di twins.

Anyway, from your pictures it looks like the babies have their own sac and the placenta looks like it's next to Baby A. In a couple of your pictures you can definately see two separate sacs, so that's good. They don't look like they are di/di at all.
If you have any pictures from a later scan, don't forget to look for the T-sign that the dividing membrane makes, that's another indications they are mono/di. If the membrane forms a lambda sign (basically a filled in V) from the placenta then they are more than likely di/di, they could be fraternal or identical in that case. It's all so confusing sometimes!! :huh:


Congratulations on your twin pregnancy!

 

Those are incredibly detailed u/s photos. They're the best I've ever seen.

Yes. They are mono di.. identicals. No doubt. 100%!

good luck and congrats!

oh and you DO need to be seeing a Perinatologist or MFM in the mono di situation. It is high risk and needs high monitoring.

You can CLEARLY see the membrane.. it looks like two circles (amniotic sacs) around the babies and then the huge black hole is the chorion. Sooo cool. I'm totally impressed by the pics!

 

After 11 weeks, it is very difficult to tell if a placenta is one placenta or two fused with any true certainty. Based on u/s, docs can guess but that's all it is, a guess. Since the u/s techs seem to be having trouble agreeing, you should proceed under the assumption that they are mono/di. They may not be but you should follow a medical plan for the higher risk situation. That means you should get u/s at least every two weeks starting at 16 weeks to watch to TTTS.

This early along in the pregnancy, I don't believe TTTS is an issue just yet. I've definitely never heard of it happening so I wouldn't worry about the size difference. For diagnosing TTTS, what actually matters more is the amount of amniotic fluid in their sacs.

 

Okay, so the tech that did my U/S on Thursday just dropped off the pictures that she forgot to give me. YAY! Here I thought I just wasn't going to get any. Anyway, I have a question for those of you that seem to really know your stuff about u/s pictures. Can you see the placenta(s) in any of these pictures and if so, where is it? Also, in the second picture just above baby A's nose and then under it's little tushie is what looks to me like the membrane, is that what others are seeing? AND, if you are REALLY GOOD does anyone see the lambda or T sign that would indicate one placenta or two fused? Thanks for everyone's input. I know I should just be patient and wait to see what the doc has to say, but this way more fun!

Take care,
Jenn

http://i53.photobucket.com/albums/g59/j_j0.../US010809-3.jpg
http://i53.photobucket.com/albums/g59/j_j0.../US010809-4.jpg
http://i53.photobucket.com/albums/g59/j_j0.../US010809-5.jpg
http://i53.photobucket.com/albums/g59/j_j0.../US010809-2.jpg
http://i53.photobucket.com/albums/g59/j_j0...cy/US010809.jpg

 

I suck at ultrasound pictures, but I just wanted to let you know we could never find any signs that our placentas were fused, but they were.

 

QUOTE(Tarin @ Jan 12 2009, 08:57 PM) [snapback]1144247[/snapback]
I suck at ultrasound pictures, but I just wanted to let you know we could never find any signs that our placentas were fused, but they were.



Thank you! They are telling us the babies are mono/di so we will just go with that for now. I suppose if we find out they are boy/girl we will know b4 birth, otherwise I guess we will just have to wait and see. Hope all is going well with you and your little guys!

 

I don't judge by the placenta. I only judge by the chorion (big black circle) yours are in the same chorion. They are identical.

 

QUOTE(MommaJ @ Jan 12 2009, 01:00 PM) [snapback]1143634[/snapback]
Okay, so the tech that did my U/S on Thursday just dropped off the pictures that she forgot to give me. YAY! Here I thought I just wasn't going to get any. Anyway, I have a question for those of you that seem to really know your stuff about u/s pictures. Can you see the placenta(s) in any of these pictures and if so, where is it? Also, in the second picture just above baby A's nose and then under it's little tushie is what looks to me like the membrane, is that what others are seeing? AND, if you are REALLY GOOD does anyone see the lambda or T sign that would indicate one placenta or two fused? Thanks for everyone's input. I know I should just be patient and wait to see what the doc has to say, but this way more fun!

Take care,
Jenn

http://i53.photobucket.com/albums/g59/j_j0.../US010809-3.jpg
http://i53.photobucket.com/albums/g59/j_j0.../US010809-4.jpg
http://i53.photobucket.com/albums/g59/j_j0.../US010809-5.jpg
http://i53.photobucket.com/albums/g59/j_j0.../US010809-2.jpg
http://i53.photobucket.com/albums/g59/j_j0...cy/US010809.jpg


I posted previously about your other sonograms, as ivfbound078 posted......your sonograms show you have two amnions and one chorion.....that's mono/di for sure.

Can you see the placenta(s).....
I see the placenta above Baby A

in the second picture just above baby A's nose and then under it's little tushie is what looks to me like the membrane.....
It looks like the membrane and if it is it goes straight into the placenta which means it's the T-sign. Also in this picture it looks like there may be a gender nub shot although it's a bit on the light side. If you are interested in what others think about that you can google in-gender and go to their website (if you haven't already). It's a fun site to upload your sonograms to and have others guess the gender of your baby/babies. Almost everyone got mine right. It was fun. (I know not everyone wants to know the gender before the babies are born, but I thought I would mention it in case you are interested. Who knows, the nub may not be as visible as I think it is.) Whatever gender they are, it looks like you are going to get two of the same!! Congratulations. :clapping: :clapping:

does anyone see the lambda or T sign ......
It kind of looks like the T-sign in your second picture, but you don't really have to see it because you can tell in your previous pictures that they are mono/di. :yahoo: :yahoo:

I know I should just be patient and wait to see what the doc has to say, but this way more fun! ......
I couldn't agree with you more!! It is tons of fun!! :rotflmbo: :rotflmbo:

Congratulations on your identical twin pregnancy, here's to a happy, healthy twin pregnancy and beyond!! :drinks:

 

QUOTE(Soon to be Mom of 4 @ Jan 13 2009, 02:07 PM) [snapback]1145358[/snapback]
I posted previously about your other sonograms, as ivfbound078 posted......your sonograms show you have two amnions and one chorion.....that's mono/di for sure.

Can you see the placenta(s).....
I see the placenta above Baby A

in the second picture just above baby A's nose and then under it's little tushie is what looks to me like the membrane.....
It looks like the membrane and if it is it goes straight into the placenta which means it's the T-sign. Also in this picture it looks like there may be a gender nub shot although it's a bit on the light side. If you are interested in what others think about that you can google in-gender and go to their website (if you haven't already). It's a fun site to upload your sonograms to and have others guess the gender of your baby/babies. Almost everyone got mine right. It was fun. (I know not everyone wants to know the gender before the babies are born, but I thought I would mention it in case you are interested. Who knows, the nub may not be as visible as I think it is.) Whatever gender they are, it looks like you are going to get two of the same!! Congratulations. :clapping: :clapping:

does anyone see the lambda or T sign ......
It kind of looks like the T-sign in your second picture, but you don't really have to see it because you can tell in your previous pictures that they are mono/di. :yahoo: :yahoo:

I know I should just be patient and wait to see what the doc has to say, but this way more fun! ......
I couldn't agree with you more!! It is tons of fun!! :rotflmbo: :rotflmbo:

Congratulations on your identical twin pregnancy, here's to a happy, healthy twin pregnancy and beyond!! :drinks:



Thank you so much. I figured from our first pictures that they were identical b/c of the difference I saw in other u/s with the two completely different "black holes" but reading other stuff online I couldn't convince myself of it. It all kept talking about the placentas more than the chorions. I am so obsessive about all this, it's crazy! LOL
I appreciate your feedback and for giving me that site to go to. I can't wait to find out the gender! I am assuming since you pointed it out you have a guess as to what we are having....please tell!!!!
Take care!

 

QUOTE(MommaJ @ Jan 13 2009, 11:20 AM) [snapback]1145377[/snapback]
Thank you so much. I figured from our first pictures that they were identical b/c of the difference I saw in other u/s with the two completely different "black holes" but reading other stuff online I couldn't convince myself of it. It all kept talking about the placentas more than the chorions. I am so obsessive about all this, it's crazy! LOL
I appreciate your feedback and for giving me that site to go to. I can't wait to find out the gender! I am assuming since you pointed it out you have a guess as to what we are having....please tell!!!!
Take care!


You're welcome. I too am obsessed with twin issues. Especially identical twins, the subject is rather facinating to say the least. I know most people say identicals are random, but I don't fully agree with that, I think they are considered random and/or a fluke because there hasn't been enough research done to find out why it occurs. There has to be a reason, it doesn't just happen, something has to make it happen. That's just my opinion anyway. I've read somewhere that it's possible there is an enzyme in the male sperm that makes the egg split. And get this, they call it super sperm. Great....one more thing to make a man's chest puff out and his head swell up (no pun intended there)!!!

One of your pictures looks like there is a little gender sign, but I could be wrong. The site that I gave you has a forum for guessing the gender from sonograms. I think it's run by an ultrasound technician. I read on the site that there is a nub you can see at about the 12 week scan, but the scan has to be a profile scan, not a potty shot. It's a fun site, you should try it.
I'm thinking if there is a nub there, it looks like a boy nub to me, but of course I could be wrong. If you put your sonogram up on that site maybe you'll get some answers from others. The sonogram that I'm guessing from is this one: http://i53.photobucket.com/albums/g59/j_j0.../US010809-4.jpg. It's a bit on the light side, but the nub might be there.

Lots of luck and congratulations again!!

 

I just want to comment on the "gender nub", be careful at 12 wks both male and female's have the "nub" still It's around week 14-16 that it starts to change into the specific gender, pointing more outward for a boy and retracting in for a girl! That nub either becomes a penis or a clitoris

I do see the nub you are talking about but it's hard to tell if it's male or female yet, pretty early to guess

 

QUOTE(Soon to be Mom of 4 @ Jan 14 2009, 02:47 PM) [snapback]1147141[/snapback]
You're welcome. I too am obsessed with twin issues. Especially identical twins, the subject is rather facinating to say the least. I know most people say identicals are random, but I don't fully agree with that, I think they are considered random and/or a fluke because there hasn't been enough research done to find out why it occurs. There has to be a reason, it doesn't just happen, something has to make it happen. That's just my opinion anyway. I've read somewhere that it's possible there is an enzyme in the male sperm that makes the egg split. And get this, they call it super sperm. Great....one more thing to make a man's chest puff out and his head swell up (no pun intended there)!!!

One of your pictures looks like there is a little gender sign, but I could be wrong. The site that I gave you has a forum for guessing the gender from sonograms. I think it's run by an ultrasound technician. I read on the site that there is a nub you can see at about the 12 week scan, but the scan has to be a profile scan, not a potty shot. It's a fun site, you should try it.
I'm thinking if there is a nub there, it looks like a boy nub to me, but of course I could be wrong. If you put your sonogram up on that site maybe you'll get some answers from others. The sonogram that I'm guessing from is this one: http://i53.photobucket.com/albums/g59/j_j0.../US010809-4.jpg. It's a bit on the light side, but the nub might be there.

Lots of luck and congratulations again!!


YEAH!!! I will have to let you know if you are right. We want boys. I did go onto that site and post the pictures but I am getting mixed guesses. It is fun though to look at all the pics and read guesses from everyone. I had read about the nub as well and I think I see what you are talking about. If I remember right it said a girl nub will be straight out and a boy nub will have an upward angle. That charliecat or whoever that people plead with on in-gender to guess the sex and a few others stated they couldn't see a clear enough nub to make a guess. SO, if you are right about mine I will have to let everyone on in-gender know that charliecat has some competition! LOL

I will have to NOT mention the super sperm theory to my husband because he would be just the type to walk around telling everyone with his chest puffed that he delivered the SUPER SPERM! Men... :rotflmbo:

Take care!

 

QUOTE(Danibell @ Jan 14 2009, 03:42 PM) [snapback]1147247[/snapback]
I just want to comment on the "gender nub", be careful at 12 wks both male and female's have the "nub" still It's around week 14-16 that it starts to change into the specific gender, pointing more outward for a boy and retracting in for a girl! That nub either becomes a penis or a clitoris

I do see the nub you are talking about but it's hard to tell if it's male or female yet, pretty early to guess



Yeah, I knew it was early but we are having fun with it. Not taking any of it to heart. Thank you for being concerned though and I will certainly let everyone know what the nub turned into!!!

 

QUOTE(MommaJ @ Jan 14 2009, 03:48 PM) [snapback]1147256[/snapback]
Yeah, I knew it was early but we are having fun with it. Not taking any of it to heart. Thank you for being concerned though and I will certainly let everyone know what the nub turned into!!!



I figured I just didn't want you to get your hopes too high yet I've heard of so many who had guesses at 12/14 wks and then they were wrong and they were disappointed! :hug:

 

QUOTE(Danibell @ Jan 14 2009, 12:42 PM) [snapback]1147247[/snapback]
I just want to comment on the "gender nub", be careful at 12 wks both male and female's have the "nub" still It's around week 14-16 that it starts to change into the specific gender, pointing more outward for a boy and retracting in for a girl! That nub either becomes a penis or a clitoris

I do see the nub you are talking about but it's hard to tell if it's male or female yet, pretty early to guess


True about the gender nub at 12 weeks. One of my nub shots was guessed girl at 12 weeks and she was confirmed girl at my 19 week scan. Baby B didn't show a nub shot at all, she wasn't confirmed girl until about 25 weeks.

It's fun to guess if one is interested in doing so, as long as they realize it's only guesses.