Possible TTTS at 28 weeks...

I had a growth scan at my appt. Wed (28 weeks 1 day) and Baby B's head, abdomen and femur were all consistant and right where they should be for 28 weeks. Baby A's abdomen measured 2 weeks behind her head and femur, which both of those were right on target. My Dr. is a little concerned... he measured it several times. He's suspecting early TTTS... but wants to recheck the measurements in 2 weeks. If they are the same or lower, he'll send me to a specialist. I don't see a perinatologist as my pregnancy has been very normal so far. This is the first somewhat scary event. Baby A's estimated weight was 984g (2 lb 2.7oz) and Baby B's weight was 1084g (2 lb. 6.2oz). I'm trying really hard not to get upset about this... they need all of me right now and if I fall apart, it will affect them. I'm trying to eat more protein. My Dr. said there is nothing I could do except eat enough. My total wt. gain is 27pounds at this point. Is the protein thing what I should do? I don't understand why just the abdomen measurement was lower... shouldn't it be all 3 measurements? I thought about that after the fact.

 

I don't have any experience with TTTS, but I'm glad they are keeping a close eye on things. :hug: You are doing the best thing you can right now, and like you said, try not to worry about it (I know it's much easier said than done). :hug:

 

I had the same thing happen to me around 28 weeks. When they did their measurements, they was a 20% difference in size (had been 15% difference the prior month). They weren't too concerned because the smaller baby was considered normal sized.
They guessed that their growth spurts may have been off a little so brought us back 2 weeks later to do a re-check. When we went back, the little one had caught up and they were back to 14% difference. All I did was make sure I was eating enough and decreased my activity level (they didn't tell me to do this; I just did it on my own).
At 28 weeks, at least in my case, there's not much they would do if one is lagging behind. The peri said they would just start the biophysical profiles earlier and monitor them for fetal distress for potential early delivery. But, they told me not to worry (HARD to do) but luckily it worked out for us. Good Luck!

 

First of all, don't panic! Did your Dr. say anything about their fluid levels? TTTS is diagnosed when fluid levels are vastly different, NOT by size difference. It will be good for you to be monitored by a Peri regardless. Maybe you can call your Dr. on Monday and ask about the fluid levels. There is no need to worry for 2 weeks over nothing. My little boy had Intra Uterine Growth Restriction (IUGR) where he wasn't growing at the same rate as his brother due to a placenta issue. There are a lot of us here who have IUGR babies and I believe there is a sticky (maybe in the health forum) of all of our stories. I hope this helps!

 

I was diagnosed with TTTS at 28 weeks and put in the hospital all on the same day. My babies fluid levels were very very different but their sizes were about the same, believe it or not. The good thing is you are being watched closely and if, God forbid, your babies do have TTTS, they can be delivered safely now. 28 weeks is a huge milestone. Keep us posted and best of luck!

 

:hug: I don't have any experience with TTTS, but I am glad they are going to be watching it carefully. Keep in mind, that although 28 weeks is extremely premature is is a HUGE milestone and many 28-weekers go on to be just perfect (my girls were born at 28 weeks 1 day). You are right about staying positive and not getting stressed out, as that is the last thing your babies need right now. Good luck and Keep us posted!! :hug:

 

:hug: I am sending many positive thoughts your way Momma! Please keep us updated.

 

Cindy - try not to stress too much and just in case increase your protein - ensure is great for that and the chocolate doesn't taste too bad either. As a couple others said, I would call your doctor to inquire about the fluid levels and the size of their bladders - that is more of an idicator of TTTS than a size discrpancy. Also, go ahead and ask for the referral to a specialist immediately just in case. You should definitely have it checked out by them before 2 weeks, at the very least by your OB. If it is indeed TTTS, it can progress fairly quickly and you are far enough along to deliver two happy healthy babies if the need arises.

I was diagnosed Stage 2 TTTS at 19 weeks. Both babies were the same size, but my recipient had 10 cm of fluid and my donor had only 2 cm. Also, my donor did not have much of a visible bladder. My MFM had me on my way to Houston that night for an evaluation for the laser surgery the next morning.

I don't want to freak you out - everything is probably fine as far as TTTS goes. You should have been seeing a specialist as a precaution since about 16 weeks if your babies share a placenta, even if everything has been fine thus far. That's weird that you haven't yet.

 

Hi Cindy –just like Texasmom0f5 said “ try not to stress too much”

Are your twins identical? Do they share one common placenta? That is the common denominator for TTTS. If yes to being identical and they share a placenta then you should be followed very closely.
The placental share could be the cause of the size difference or the simple fact that when they split early on and one twin got a larger share of the cells and is just going to be larger.
Key factors for identical twins.

1. You should have an ultrasound every 2 weeks and a highly specially trained Maternal Fetal Specialist looking for fluid volume differences, in each sac, checking to see if there bladders are seen, and checking the Doppler studies, there are 3, a cord Doppler reading in the middle of the umbilical cord, not the insertion site, the Ductus Venous (the most difficult to obtain) and the MCA’s (middle cerebral artery). Abnormal findings can also lead to the detection of SIUGR (selective intrauterine growth restriction)
2. Every 4th week this scan should include a growth scan to measure for growth issues. This is very difficult to measure less than 3 weeks. The babies need time to show integral growth since the measurements are so small.
3. An internal ultrasound measuring your cervical length, this should be done on the initial ultrasound and then every 4 weeks unless sign and symptoms are different.

Good news is 28 weeks ! Ask your doctor if they feel the chanced of an early delivery….maybe a visit to your local NICU and possible steroid injections for lung development for the babies.