TTTS and delivery

So i've been reading about TTTS, so far i think TTTS only occurs in identical twins, correct?

So educate me about TTTS and delivery... Mine are Mo/Di they're both head down currently and hopefully they stay that way. So are there risks of having a new complication of TTTS during delivery that wasnt previously diagnosed that would cause an issue with the twins. Or are the risks with delivery that i've read about from a case of previously diagnosed TTTS, that causes issues with delivering naturally?

I hope i explained that right...

I'm just trying to look at the facts about possibly having a natural delivery,

 

My little men were diagnosed at 20 weeks, when I had the Level 2 sono and found out they were boys.
I had an emer. C section, but that was b/c of the TTTS.
Has you dr. said you have it?

 

QUOTE(JakeandPeyton @ Apr 26 2008, 01:33 PM) [snapback]740986[/snapback]
My little men were diagnosed at 20 weeks, when I had the Level 2 sono and found out they were boys.
I had an emer. C section, but that was b/c of the TTTS.
Has you dr. said you have it?



no.. both babies appear to be normal and healthy.... i'm want to try a natural delivery and i think i scared myself just reading about it, someone had said anyone with mo/di should have a c-section because the risk of ttts issues at delivery, giving the babies problems. I'm just wondering if i have a chance at a normal delivery or if its too risky and i should just prepare for a c-section. I have no problem with having one, i'm just going to prepare differently if thats the best option. I'm not sure if i understand what i've read so i want someone to fill me in.

 

I actually posted a thread asking about mo/di twins and delivery just last week. here is the link. Many of the moms that delivered mo/di twins replied to my thread. I am just a few weeks further then you and am also hoping for a natural delivery.

http://www.twinstuff.com/forum/index.php?showtopic=68513

 

thank you... i honestly have no idea what i want to do... I want to try a natural delivery, but i almost just want to forgo the risks... and just go with a c-section i'll have to talk to my dr and see how she feels.

 

I had a vaginal delivery with TTTS. My OB and perinatologist watched my babies via ultrasound during my delivery and I delivered in the OR (most twin deliveries are in the OR). I felt safe because they were well monitored.

 

My babies have changed positions many times since 22 weeks, just to give you a head's up that position can change - and it's normal. I have mono/di twins with TTTS, and my docs are pretty conservative. . . Looks like I will be having a c-section because they feel it is safer and will eliminate increased risks for the twins. Sure, I'd prefer a natural delivery if the babies presented themselves accordingly headdown, but because of the TTTS already and what we've gone through, I'll do anything just to get my babies here safely.

There's some talk that acute TTTS is still a possibility during the labor/delivery even for babies who have shown no signs of the syndrome previously. BUT that's not to say that mono/di babies can't be delivered vaginally. I think many people have had success with that, and that's encouraging. I think making sure your docs are monitoring the babies closely and know how to deliver mono/dis to decrease complications is important. It's obviously a very personal decision.

I was told that my history of precipitous labor was actually a plus for vaginal delivery of twins in this situation because apparently a prolonged labor/delivery experience can cause distress to the vascular structure of the placenta that results in TTTS. (Strong contractions apparently have contributed to cutting blood flow/etc. from one baby to other during some labor which ended up with demise or damage to one baby.) I don't know how true that school of thought is, but either way, it's something to discuss with the doctor or do more research about.)

If I had not had a TTTS diagnosis already, I would be pushing for a vaginal if at all possible! Best wishes for a very smooth, vaginal delivery for you if that's what you really want!!

 

Being on bedrest and all, I've got time to dig such things up. . . I've linked some discussions concerning this issue. At the bottom of that linked page are three links to other discussions concerning c-section vs. vaginal in monochorionic pregnancies. Some quite impassioned, but food for thought.

http://www.monoamniotic.org/cgi-bin/ultima...c;f=16;t=000189

I really wish I could do a vaginal, but after reading some of this and having stage 1 TTTS for 6 weeks, I just can't put my babies at risk further.

 

Mine had TTTS - I had a c-section, but that was mainly because they were both breech - and I delivered at 38w4d, so they weren't going to flip.

I think my peri would have delivered vaginally if baby a was vertex, but I probably would have opted for a c-section anyway. If they were both vertex, I may have thought about it. In hindsight, I'm glad we had a c-section, at 38w4d, by babies were only 5lb2oz(B) and 6lb1oz (A) My little one had apgars of 3/8 and needed some oxygen, even then. I'm not sure she would have made a vaginal delivery. Maybe she would have, who knows. She was very pale, and the other was very red.

So, I'm not sure what I would do - I guess I would wait until you need to make a decision, I guess - mine flipped around all over until about 33 weeks.

Good luck!
Jenny