Scared About Twin Growth ...

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Hi Ladies,

I am new to this board. I am 31 yo and 29 weeks pregnant with b/g IVF twins.

Up until now this pregnancy has been very easy, however at our growth scan ultrasound yesterday they detected that baby A (our little girl) is not growing as well as she should be. At our first scan 8 weeks ago, she was in the 60th percentile for weight. 4 weeks ago she dropped to the 38th percentile; this time around she was only in the 8th. Her brother's numbers are dropping too ... he went from the 86th to the 75th to the 45th, but he is much larger and so still in the normal range.

Baby A's head measurements were good, in the 50th percentile, and her femur and humerus numbers weren't terribly low (in the 20s). However, her abdominal circumference was only the 5th percentile. This is mainly what's dragging her down to the 8th percentile overall. They estimate she weighs 2 pounds, 6 oz (compared to her brother's 2 lbs 14 oz). This is about a 17% growth discordancy; I know they don't like to see anything over 20%.

Baby A's fluid and blood flow through her cord looked good, so they said the best course of action is just to watch her closely and see how she does. I go back in another 2 weeks (so far away!) for another scan to check her growth. In the meantime, my OB pulled me out of work as a precaution, and I'm supposed to spend most of my day laying down on my side (with the hopes of increasing blood flow to her placenta). OB says the scan suggets her placenta isn't functioning optimally, and guesses this will lead to an early delivery (likely between 33-35 weeks).

Sorry for the long intro, but I am absolutely terrified for our little girl. She's so tiny, and I'm so worried she will stop growing. I'm also worried about the possible adverse effects of her not getting all the nutrients she needs. I guess I'm interested to hear if others have had experience with one (or both) of their twins being so tiny and what the outcome was - i.e., did bedrest help any, how early did you deliver, what was the effect on the babies?

Thanks for helping to ease my mind ... 2 weeks is a long time to wait, particularly with all this time to lay around and think about things.

 

Hi there & :welcome: to Twinstuff!!
Big :hug:s to you ~ I can imagine that you are feeling pretty stressed out right now.
It is good that they are monitoring you closely & having you on bedrest.
Bedrest helped me A LOT! :good:
I know there are plenty of moms on here that delivered early & they will have great advice/stories for you.
In the meantime, try to hang in there & relax as best as you can

 

I can completely relate! Our little ones are measuring 24% apart. When I questioned the peri about what I could do, he said the best thing for them is my bed rest. So, take it seriously. I've fallen into the trap of boredom/needing to clean my house once already and it's not worth it. As difficult as it is to lay in bed for hours, do it!

:hug: s to you and your little ones!

 

One of my girls was diagnosed with IUGR (Inter uterine growth restriction) which means, too small. And they never figured out why. (Except perhaps her HORSE of a sister was taking ALL the nutrients) She was born at 38 weeks at 5.7. The smallest of any of my kids by a LONG shot. And to this day although others think she is large, she is by far the smallest of my kids. Somehow God just gave me one normal sized kid.

I do recommend doing as little as you can and getting in all the calories you can. Ice cream before bed, and lots of Ensures. I worried SOOO much about my little one and now she's my SPITFIRE!

 

Hi! And welcome to Twinstuff! I'm so happy you found us. :hug:
I'm sorry to hear about what's been going on with your baby girl. :hug: I am hoping that the bedrest helps things and that the two weeks fly by for you. Please keep us updated on everything. :hug:

 

Hi and Welcome to TS!

I'm sorry to hear about your little girl. I think the dr's are being very proactive and doing what is best for you and your babes, just do everything they say. Take it easy! PP's are correct- try to eat lots of protein. Try protein bars, I eat them and they are pretty good (20 grams of protein per bar).

We have a few things in common! I just turned 32 and am 31 weeks preggers with girls thanks to IVF!

Try not to worry or be too stressed, just relax and eat!

 

:welcome: to Twinstuff! I'm sorry to hear what is going on. :hug: You've gotten some great advice so far. Keep us posted.

 

Hello and Welcome. I have no information for you but wanted to say that I am thinking of your little one.. I am sure all is well. Hugs.

 

I an 27 weeks pregnant with b/g IUI twins and found out the same thing on Monday.

We were in great shape up until this appointment. Baby A (boy) is 1 lb 14 oz in the 25th percentile and Baby B (girl) is 2 lb 1 oz in the 45th percentile... they were big for their fetal age four weeks ago. My doctor also asked me to limit activity/work to 1 hour a day. I asked if I needed more protein or to make any dietary changes and they said no, that activity level was the most important.

I have no advice, but I'm right there with you. Stressed and worried. I can't help but think they have both really slowed their growth in the last few weeks, him especially. We found this link to a growth chart that gave us some more information on average sizes, you might find it helpful as well. Our sonographer said they don't measure twins any different than they do singletons, that our babies are held to the same statistical standard on these models.

http://www.babycenter.com/average-fetal-length-weight-chart

QUOTE(Lawyerlady @ Sep 25 2008, 12:24 PM) [snapback]997210[/snapback]
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Hi Ladies,

I am new to this board. I am 31 yo and 29 weeks pregnant with b/g IVF twins.

Up until now this pregnancy has been very easy, however at our growth scan ultrasound yesterday they detected that baby A (our little girl) is not growing as well as she should be. At our first scan 8 weeks ago, she was in the 60th percentile for weight. 4 weeks ago she dropped to the 38th percentile; this time around she was only in the 8th. Her brother's numbers are dropping too ... he went from the 86th to the 75th to the 45th, but he is much larger and so still in the normal range.

Baby A's head measurements were good, in the 50th percentile, and her femur and humerus numbers weren't terribly low (in the 20s). However, her abdominal circumference was only the 5th percentile. This is mainly what's dragging her down to the 8th percentile overall. They estimate she weighs 2 pounds, 6 oz (compared to her brother's 2 lbs 14 oz). This is about a 17% growth discordancy; I know they don't like to see anything over 20%.

Baby A's fluid and blood flow through her cord looked good, so they said the best course of action is just to watch her closely and see how she does. I go back in another 2 weeks (so far away!) for another scan to check her growth. In the meantime, my OB pulled me out of work as a precaution, and I'm supposed to spend most of my day laying down on my side (with the hopes of increasing blood flow to her placenta). OB says the scan suggets her placenta isn't functioning optimally, and guesses this will lead to an early delivery (likely between 33-35 weeks).

Sorry for the long intro, but I am absolutely terrified for our little girl. She's so tiny, and I'm so worried she will stop growing. I'm also worried about the possible adverse effects of her not getting all the nutrients she needs. I guess I'm interested to hear if others have had experience with one (or both) of their twins being so tiny and what the outcome was - i.e., did bedrest help any, how early did you deliver, what was the effect on the babies?

Thanks for helping to ease my mind ... 2 weeks is a long time to wait, particularly with all this time to lay around and think about things.

 

Just a reminder. Of they are B/G twins. They are more like siblings with the same birthday, when it comes to size comparison and weights.

It sounds like your doctor is right on. Keep your feet up, and the food coming ! Youre in our thoughts! I hope all turns out wonderful for baby girl HUGS!!! :hug:

 

My guys were full term and they never measured too much different, but the one thing I can point out is that those growth ultra sounds are not totally accurate. At my last ultra sound appointment, which was 2 weeks before my 38 week delivery, my guys supposedly measured 6lbs. 4oz. and 6lbs. 6oz. When they were born one weighed 7lbs. 3 ounces and the other was 6lbs. 5 oz. They should have both been just over 7lbs at birth based on the typical growth pattern, but they were way off on my one guy. My friend who had twins had the same scenario--u/s was off by a pound.

The ultrasounds are estimates; they are not perfect. Just make sure you rest, and stay calm. I'd bet that everything will be fine.

 

I understand! Just have faith that they will do well. The doctors will do all that they can.

My girls were discordinate..Kaylen was half the size of Kylie (believed to be caused by blood clot on her side of placenta). The doctors had me come back evey week for dopplers etc..every 3 weeks i think they did measurments. They came out little but are healthy 8month olds!
My doctor told me to rest and stay off my feet as much as possible. Bed rest does help! I delivered them at 32 weeks due to Kaylen not getting enough oxygen. They stayed in the NICU for a couple of months. They were on oxygen for a little bit but their lungs matured well. There haven't really been any side effects except for delayed milestones (?) which is fine. They are 8mnths but only expected to do things a 6month old is doing. All in all they are doing really well.

Listen to what your doctors say, always stay positive!!!! Good luck, I hope you twins come out healthy healthy!

 

Thank you so much for all of the support and encouragement ladies. I'm really optimistic that things will work out, it's just hard not to be worried about our little girl in the meantime. One reason the OB doesn't think she is just constitutionally small is she is not proportionally small - her head is normal but her abdomen is teeny. Apparently this is suggestive of a nutrient delivery problem. I won't have another growth scan for a week, but I have my 30 week appointment tomorrow so I plan to ask the doc a million and one questions ... I'll keep you posted.

One thing that I think is strange is that people have said increasing caloric content won't really help. I wonder why that would be? Even if the placenta is only giving her a percentage of what it should be, if you increase the overall number of calories shouldn't she still get more in the end?

MrsS - sorry to hear you are in the same boat. At least we can go through this together. Keep me posted on what happens. If it makes you feel better, I've been told they don't worry too much about size until you get down below the 10th percentile. So you're still OK!

 

I had a tiny one due to TTTS and she was actually the healthier of the two babies when they were delivered. :hug:

Make sure to take your doctor's advice and rest on your left side as much as you can during the day. Get yourself some drinks and snacks in the morning and set up a little bed for yourself on the couch in front of the TV. Drink tons of water and it would probably be good to also get yourself a case of protein drinks so you can sip a couple throughout the day. You want to get as much nutrition inside yourself as possible.

My little girl was the donor twin for TTTS and she had a 2-vessel umbilical cord so she really had a double-whammy against her growth-wise. I have never eaten as much food in my life as I did during those 15 weeks between when we discovered the twins and when we delivered them. The protein drinks helped as well. I needed to get as much nutrition to her as I could and it worked out well for us. She was only 3 lb 15 oz at 35.3 weeks but she was healthy and spent 7 days in the Special Care Nursery until she proved she could eat and grow well. She came home 2 days before her bigger sister who was in the NICU.