scared. ttts worry.

Hi,

I had my growth scan last Friday. (I'm 29wks today). From what I could see there seemed to be a difference in their sizes/weights but DH swore he saw the tech write down that it was a "normal" scan and she didn't say anything to the contrary to us. So, I wasn't worried. I was finally feeling like maybe, just maybe we're going to make it these last 6 weeks and find ourselves among the lucky who have identicals w/o TTTS.

Well. I got a call from my midwife this afternoon and she said that she was looking over the u/s and talking w/ the dr advising the midwives (we have a midwife group and the policy is after 20 wks an obgyn informs/stays in the loop) and the u/s tech and they noted there is a discordance between the two. Baby A is 2lb 5oz and baby B is 2lb 10oz (initially the tech showed us their weights and it was a little different, 2lb4 & 2lb7 I believe, so they must have gone back over it again and figured differently). She said everything else looked good (heads are down, good placenta, good fluid, still can see the membrane, good blood flow, & cervix hasn't budged, still very long) so that at my next appt (this Friday) I should make an appt for 4 weeks out (originally recommending 6wks).

I was exhausted enough I managed to sleep for an hour after that but woke up w/ my heart pounding and my mind reeling because I'm so scared they're developing TTTS. The added worry for me is that if we have to deliver the babies before 34wks we have to go to the next town over (our hospital doesn't have a NICU) which is okay- but I've got a toddler at home and it'll be so hard to be visiting our babies and making enough time for him, too.

On top of all this, I've sort of suspected something was up. Baby A just doesn't move like her sister. She moves, I can feel her if I really pay attention, but not like Baby B who is constantly changing positions and kicking or hitting, etc. (Baby A is a little deeper back, too).

Just wondering if there's anyone that can offer some reassurance or a prod to take action-- should I just try to relax in the fact that I've had no pre-term labor symptoms, that if they come now they've got a very good chance of survival, and that the midwife wasn't saying "get your bum down here now!" or... are there those of you who know differently and would say, it's not worth taking chances, get another scan soon or similar.

trying not to freak out but it's a little hard,
thanks for listening,
Lynn

 

I know it's hard not to freak out, but try not to... TTTS is scary but you're far enough along that even if they were born now they have an excellent rate of survival and it doesn't sound like you're in danger of delivering, so try not to worry! The difference in their weights isn't that much and as long as their fluid levels are good then that's a very good sign. The size discrepancy with TTTS isn't so much an issue as the fluid levels- it's when one baby gets more nutrients and isn't making enough amniotic fluid or is making too much is when they start to worry (I think)... I'm surprised, though that they're not doing u/s every 2 weeks- I had them every 2 weeks starting at week 18 because my boys were identical and shared a placenta. You might want to ask about that.... As far as the movements of Baby A vs Baby B- I always felt my baby B more and worried too about Baby A, but their position has so much to do with how much you feel. Even at my last u/s at 33 weeks, I was amazed at how much movement I couldn't feel but could see on the u/s screen- I was so stretched out that I thought I could feel them blinking, but our bodies are pretty surprising! If you're really concerned, though, call your ob, that's what they're there for!! Good luck!!!

 

I agree with Jenn G - you are far enough along that if you delivered now they would probably be ok - yes, they would be in the NICU, but they would probably be fine. I also agree that the size discrepancy isn't as important in TTTS as fluid levels. If they can see the membrane and the fluid levels are ok and the cord dopplers are ok then you are probably ok. Those are things to look for - fluid levels, abnormal dopplers, increasing size difference, visible bladders.

We did have TTTS starting at 18 weeks, and we did not end up having the laser surgery (which they only do until 26-27 weeks anyway) but I was on bedrest and drank protein drinks. I also had a 16 month old at home. I made it 21 weeks on bedrest, and they stayed stable, and delivered healthy with no NICU time at 38w4d. My advice to you - take it easy - do as much bedrest as you can - eat plenty of calories, drink lots of water - focus your energies and nutrition on your babies.

TTTS is indeed scary. You can go to the tttsfoundation.org website message boards and ask the ladies there as well. It is goo dyou are being monitored, I would insist on it - it can come up at any time.

And, most identicals sharing a placenta do have some sort of connetcing vessels and, in that way share blood and nutrients. Many have a size discrepancy and have some signs of TTTS, although not necessarily life threatening. It is good to be monitored!

Good luck to you - we're here for you. Take comfort in the fact that all seems stable so far! That's a great sign that things will continue to be stable!

Jenny

 

:hug99: thanks.

I really appreciate the info on fluid vs. the other signs, it's comforting.
very much appreciated.

Lynn X

 

Although some do, most identical's don't weigh the same at birth. 5 oz is still pretty close. The promising fact is that they both have good fluid.

 

I ahve fraternals, but I was a nanny for MoMo twins delivered at 36 weeks. They did not have TTTS but the mom spent 2 weeks in the hospital before they were born. They weihed 5-2 and 6-1. They were almost a pound apart. Now they are 3 and within a few ounces of one another.

Try not to worry. I know that is hard to do, as mine are 7 months old and I am still worrying. Just bake those little ones a little longer. Rest lots, drink lots of water and protein drinks if you wish. I know that they can be very beneficial.

Take it easy!

 

Lynn,

I agree with everyone else that your babies sound fine. I know everyone worries about TTTS, but I wanted to mention that many times identical twins have different growth patterns in utero and some times one is smaller than the other... without TTTS. My girls were born almost a pound apart, but they didn't have TTTS. One was getting more nutrients than the other due to cord placement in the placenta. They were both fine at birth and are about 8 ounces different now (at 9.5 months old).

So, try not to worry. You may have one baby who just had a growth spurt and the other will catch up later this week. Or maybe you have one who's going to be smaller than the other. Size difference can be many things other than TTTS.

Good luck!

 

We had ttts from 13 weeks and was induced at 36 weeks to bring home two healthy babies. No hospital bedrest but weekly monitoring from 13 weeks on. At one time we had almost a 30% growth discordance. This varied at every growth scan. They were born weighing 4lbs and 5.5 lbs. Also with sonograms the accuracy of the weights can vary so it may not be so severe. At 30 weeks we had a 21% difference baby a 3lbs 5 oz baby b 2lbs 9 oz. by 33 weeks we were up to a 26% difference(measuring more than a lb. apart) and still kept me going til that 36 week point. As long as everything stays ok otherwise you'll be ok just keep getting monitored. I did notice weeks that I was on my feet more, growth slowed down. Oh and I next to never felt baby a she stayed in pretty much the same position low and my placenta blocked her movements where baby b flipped constantly even during birth. I don't want to worry you either but I too would be pushing for biweekly monitoring just to be on the safe side. You are at a good point for survivability and good chances you will get alot farther. I wish you and the babies the best.

 

We found out we had TTTS at 35 weeks. Looking back on it there were signs as early as 20 weeks when I was put on bed rest due to PTL and a funneling cervix. Caleb had been about 5 ounces lighter than Braxton. They were born more than a pound apart and today at 8 months, they are a whopping 3 pounds apart! My advice is not to worry. Stay off your feet as much as you possibly can....seriously. It gets tempting but just remember that "cheating" is only cheating yourself and your beautiful babies. As far as movement, Caleb was the one who was way deep and towards the back and I NEVER felt him. It was so incredibly scary. The days that I stressed about it I would have so many contractions and had a couple of scary trips to L&D as a result. Another word of advice (and please don't be offended if you were one who suggested this...it's just my opinion) do not go researching TTTS. If you are anything like me, you will sit on the internet all night reading all these horrible stories and that's the only thing that will stand out in your head-forget the success stories, forget our testimonies, all of it. I just always tended to pay attention to the worst case scenario and sent myself into a (contraction-filled) coniption. If you know you're super strong and a glass half full kind of girl, then go for it. But if you know it will only make you worry, I really don't recommend it. I always tell people to visit my blog and read the first couple of posts which are background stories about bed rest and the end of my pregnancy. Then look at the recent stuff with my happy healthy baby boys! It's comforting for some people. Sometimes it helps to actually SEE real life people who have gone through it and are doing great now. Good luck to you!

 

Also, remember that the measurments can be off by a bit. At one point of my pregnancy, my girls supposedly had an 18% difference in weight and I really started to panic (we had lost a set of twins to TTTS previously). We went back in and had their dopplers checked and that was fine so it put my mind at ease a little bit. We had an ultrasound a week later and they measured much closer in size. It sounds like your babies are doing well in all other ways (normal fluid levels, etc.). The fluid levels are probably the most important sign. It takes a combination of symptoms to really be TTTS. You should probably be having ultrasounds at least every two weeks, btw. I agree that you shouldn't go read all the TTTS stories of others, but it might ease your mind to just know a couple of the signs. Because I had lost twins to TTTS I would actually measure my own fundal height with my second twin pregnancy because I knew with TTTS (with a rapid increase in fluid), fundal height can increase very suddenly (even within a few days). I think as I got farther along, I didn't do it as much. Congrats on getting to 29 weeks! Oh, I also wanted to say my girls were 11 oz. different at birth but they did fine.

 

QUOTE(denali_ice @ Feb 18 2008, 09:02 PM) [snapback]628114[/snapback]
Although some do, most identical's don't weigh the same at birth. 5 oz is still pretty close. The promising fact is that they both have good fluid.


My thoughts exactly. :hug99: You're doing a great job. It's so hard not to worry, but hang in there.

 

I have fraternals so I don't have any experience with TTTS but I can tell you that I had an u/s on my delivery day because they wanted to make sure the girls were big enough and that they didn't need to transfer me to a larger facility that deals with preemies. The weights they got on the u/s were a pound and a pound and a half off of what the actual weights were on my girls. Just remember, it's not an exact science. All in all, it sounds like you're doing great and your babies are doing great so keep it up. Also, I almost never felt baby A whereas B was kicking me like a soccer ball.