My appointment and questions....

I had my growth scan on Thursday (I'm 19.2w/ mo/di boys). The peri took my measurements and Baby A is now 20% behind his brother in weight. (one is 10 oz and the other is 8oz) and the fluid levels had both dropped. Baby B had 5.5ish and Baby A was only 3.1. The peri said that things still look normal, but he wants to start monitoring me every week for fluid changes.

It seems kinda early to have that big of a discrepancy in weight and fluid levels. Is this normal? I know my levels aren't in a range to be considered mild TTTS or anything, but how can you tell when you have TTTS v. IUGR v. normal amount of discrepancy? I just feel a little anxious over the whole thing since we still have such a long way to go, but I'm trying not to worry

If you have any advice/input or anything to reassure me that this is totally normal...I would appreciate it!
Mindy

 

The only advice I know is to rest laying on your left side as much as possible and to drink, drink, drink. I have heard some of the ladies on here recomend drinking Boost slowly throughout the day. HTH

 

QUOTE
I know my levels aren't in a range to be considered mild TTTS or anything, but how can you tell when you have TTTS v. IUGR v. normal amount of discrepancy?


I think it's possible to get all the way to birth and not know if it's mild TTTS or what. We knew we had IUGR since 27 months or so, but after the birth my OB said after the placental pathology, he *thinks* it was TTTS that was a big part of the problem.

As for advise, just do what you know you can, but in the end, don't blame yourself! :hug99:

 

I am not a doctor so I can't say if this is normal or not. I can only tell you my story. My Baby B's amniotic sac was half the size of his brother's since we discovered there were two babies at 9 weeks. This was all the way until around 17 weeks when the fluid amounts started to really even out. Then at 24 weeks we were seriously monitoring the size discordance because it was 20%/more than one pound difference and they are considered viable at 24 weeks. Baby B was having IUGR issues due to endo-diastolic blood flow. I was given two separate rounds of steroids (a huge bonus for the boys) and put on moderate bed rest with a high protein diet to fatten them up as fast as possible. We started monitoring the blood flow in the umbilical cord of Baby B every three days, then at 26 weeks was admitted for 24 hour monitoring. We delivered at 28wks 6days. They are now 5 weeks old, still in the NICU for at least another 2 to 6 weeks but they are doing really well.

I would say it's still early to tell if this is TTTS or IUGR but it does seem to be something to be concerned and monitored closely. I would also ask your Dr. about the things you can do to help the baby. Is adding fluid to assist the baby possible? Are you already on bed rest? If not ask to be put on moderate bed rest. Watch your diet, eat healthy and lots of protein rich calories. Steroid shots, how soon will the let you get them? Can you drink more fluids or can they give you an IV to assist with that?

You are so very close to viability so you need to stay positive, realistic and do everything you can to keep baking those babies. Good luck!

 

Thank you all for your responses. I go back on Thursday and hopefully things will look better. I'm trying to be upbeat, but I'm really scared for them. You are right though....we are at least getting close to viability age, so I guess we'll make that the first goal.

Thanks again for the responses.

 

I do NOT think it's too early for TTTS. I was diagnosed with TTTS at 16-18 weeks - when there was a 20% size discordance. My Baby B also had NO fluid - they could not even find the membrane. My Baby A had normal fluid. - They also had abnormal dopplers with absent end diastolic flow.

My TTTS stabilized with bedrest and Boost drinks (for 21 weeks!), and I needed no other intervention, but I was monitored weekly.

I am no doctor or anything, but your fluid levels with the maximum vertical pockets that you mentioned sound within normal range. If one gets below 2, or one greater than 9, I think then you'll be diagnosed. They also look for visible bladders in both babies, abnormal cord dopplers, and any thickening of the heart or hydrops. If those things happen, it's TTTS. It could also be placenta share issue and therefore IUGR.

In our case, not only did we have an element of TTTS, but one of them had a 2 vessel cord and velamentous cord insertion (where the cord inserts into the membrane instead of the placenta). Our fluid levels were ALWAYS on the low side - usually around 2-3. It is often more than "one" thing causing problems - that's ok - it can still be treated!

However, with a 20% size discordance, that is often the first sign of TTTS. I would want to be seen by a peri or MFM, especially because they are mo/di. If it develops into TTTS, it can happen quickly and there ARE things they can do to save your babies. But, you need to be monitored. It sounds like things are ok for now, but I would get in for a check again within a week or two to monitor for TTTS. Oh, I just saw they are going to monitor you weekly - ok - well that's GREAT! They will see somehting if things change.

In the meantime, I would take it easy, lie down as much as possible and drink lots of water, and boost your protein intake - get as much to those babies as you can!

Jenny

eta: you can come check out the message boards at tttsfoundation if you need some additional support!

 

They gave you some great advice. I just want to say that I hope things work out well. Try to rest and get plenty of fluids.