Peri appointment.. I need your opinion.

As I mentioned before.. I have never seen a Peri.. in fact I hadn't seen an OB in over 6 years until just a few weeks ago. So I am not really sure how to read them nor what the normal level of care is. So I need you all to give me your opinion on whether you feel its obsessive or seems about right.

ok..

Babies swapped positions. Dani is now baby A.. she is our peanut girl. and Sophia is B.

Dani is the baby that is measuring a bit behind.. she is measuring at 25 weeks 1 lb 7 oz. Sophia measured at 26 weeks 1 day (right on) 1 lb 13 oz. I had an u/s 2 weeks ago Dani measured 23 weeks 1 day..1lb 3 oz.. and Sophia measured 24 weeks 1 day (right on) and 1 lb 8 oz. So both babies seem to be growing.. its just Dani isn't growing at the same rate.

He checked fluid levels.. great, doppler flow.. wonderful, checked all her organs including the blood flow in the heart and a few things that I really have no idea what they were.. but seemed close to the heart so maybe some valves? All looked great. She moved around like crazy. He said that other then her growth.. she looks like a wonderfully healthy baby and he really has no reason to suspect TTTS at this point.. but IUGR is a concern.

Now.. I didn't really expect that he would want to see me again.. don't ask me why I just thought he would check on her and send me back to my MW and OB. But he instead said..I want to keep a very close eye on you and want you in here every week. I know that many of you see a Peri.. shouldn't it be every other week at this point?

 

My guess is that if he thinks IUGR is a concern, that's why he wants to keep a close eye on you. Many OBs just don't have the knowledge or the technology to do very accurate measurements of twins. Also, even though he's not suspecting TTTS right now, ID twins are high-risk by definition. It's not that unusual for a peri to want to see you every week at this point. I did not have ID twins, and I only saw a peri a few times, but I started going to my OB for a BP and heartbeat check every week at 29 weeks.

You can, of course, decide that you don't agree with his recommendations. But especially with a twin pregnancy, most people would prefer to be on the safe side, unless going to see him every week is just not logistically possible.

 

If it makes you feel better, I had frats and I saw my peri every week starting at 24 weeks. My little girl was always a week behind and now she does everything several weeks before her brother.

Just think of how many times you will get to see your little bundles via U/S!

 

I am sure he just wants to keep a close eye on you and your babies. :hug99:

 

Mel, we were told that the error of margin for u/s weight measurement at 26 weeks is +/- 6 ounces AND the babies' positions can also affect these measurements' accuracy. I'd keep that in mind, and I think you'll be relieved to have more peri visits so you can be sure things are good. The fact that fluids and dopplers, organs look good is great and of comfort.

Unless your peanut is measuring below 10th percentile, our docs here wouldn't even consider twins above that size to have IUGR. My MFM docs also say that where TTTS is concerned, yes size discordance can be an indicator, BUT they do not count it alone without the other symptoms to be TTTS. It may just be a placental share issue or it just could be that one is a little behind. Their growth curves may be different, and that's normal, even with mono/dis from what I've read. The biggest thing is that they are both still growing.

Our littlest guy had two weeks where he only put on 3 oz. whereas his bigger bro put on 11 oz. those two weeks. It was around 24 to 26 weeks come to think of it. But then the littlest one added more than his bro during the next cycle. Just keep up those peri visits, rest as much as possible. . . well, I think you know the routine!

 

I do agree.. I want to lean on the side of over cautious then under. I had another lady explain IUGR to me a little more as her DD had it.. it really helped to show why the Peri was concerned.... I read so much about TTTS but not much on IUGR.. so thats my homework now.

TY ladies..

 

They just want to keep an eye on you due to potential IUGR and since you are carrying ID's.

If it helps, I saw my peri pretty much weekly as well, and I was carrying fraternals. I was high risk and they wanted to keep a close eye on me.

It made me feel much, much more comfortable to know we were being watched so closely.

 

I'm sure she will be fine.
If it helps at all ... I saw my Peri all the time, especially towards the end and i had no issues through out the whole pregnancy.

My doctor just thought it was best to see the peri often for any 'just in cases'
which was fine with me.
Our technician was hilarious and even let us see the twins in 4d for free....shhh!
it was amazing

 

I would have loved to see my peri every week, I only saw him every 2-3 weeks towards the end. I think it is pretty common for them to want to see you more often and I think it's great that he wants to see you every week. If I were you I would just go with it. I wouldn't necesarily take it as a sign that something is wrong just that he is being extra cautious with your precious babes.

 

I saw the peri monthly and the OB monthly in 2 week cycles - so there were never more than 2 weeks without a doctors appt and/or u/s...I had a level II u/s monthly to check growth...and I had fraternals...

Abby (my baby B) was always between 6-10 days smaller than her brother - and it wound up working out that it was just because she was a girl - ergo genetically smaller...our Peri said unless the size discordance was 25% or a full 14 days it wasn't anything to worry about - but more to just watch...

 

QUOTE(Minette @ May 7 2008, 01:53 PM) [snapback]761408[/snapback]
My guess is that if he thinks IUGR is a concern, that's why he wants to keep a close eye on you. Many OBs just don't have the knowledge or the technology to do very accurate measurements of twins. Also, even though he's not suspecting TTTS right now, ID twins are high-risk by definition. It's not that unusual for a peri to want to see you every week at this point. I did not have ID twins, and I only saw a peri a few times, but I started going to my OB for a BP and heartbeat check every week at 29 weeks.

You can, of course, decide that you don't agree with his recommendations. But especially with a twin pregnancy, most people would prefer to be on the safe side, unless going to see him every week is just not logistically possible.

I agree. Better safe than sorry.

Good luck!