TTTS Scare

I'm scared my mono/di twins are developing TTTS.

At my 18 week U/S Baby A measured 17 weeks 4 days and Baby B measured 16 weeks 3 days. They (doc and u/s tech ) didn't give us weights or measurements other than that. Apparently their fluid levels are equal, although Baby B is sqwished up under my diaphram while Baby A is stretched out head down feet up. They couldn't adequately visualize the heart and kidneys, so no info on that. My fundal height is 23 cm.

I don't see my OB for another three weeks......which I'm trying to bump up.

I am trying to remain calm.......rest and drink the boost drinks........but I'm absulotely going out of my mind!!!

Does this sound like it could be TTTS? Up to what point can you have the laser surgery to separate the placenta?

 

Hey Jen,

I don't have any info just wanted to let you know I'm thinking of you. I hope you get some info soon.

Erica

 

Jen,
Did the doctors say they think it is TTTS? Usually the first sign is a huge difference in the fluids. One fluid is less than 2cm and the other is more than 8cm. It can not be TTTS until the fluids are at those sizes. It is possible that one of the babies has Intra Uterine Growth Restriction, but that is not as serious. I wouldn't be too concerned as u/s can vary and when the babies are difficult to get to, they get difference sizes. Even up to the week before my twins were born, they said they were over 4 lbs each. They were born a week later at 3lbs 3oz and 3lbs 14oz. U/S are not extremely accurate all the time. If you're doctors are not worried, then I wouldn't be either. If it makes you feel better, call your OB and ask them to double check the u/s results.

 

I would just express your concerns to your ob. Have they mentioned TTTS? I would try not to worry too much until you actually talk to them about the possibility. (I know, easier said than done). :hug99:

 

I haven't seen by OB yet......just the family doc. He's referring me today but said I wouldn't see the OB for three weeks. My doc said that the size difference is concerning.........but at this point there's nothing he or I can do about it........just monitor.

I'm just frustrated with the "wait and see". I'm a do-er........tell me what I can do and I'll do it. So I find it frustrating to feel out of control of the situation.

This may sound crazy but I decided in church yesterday that I'm going to "will" Baby B to grow and both to be healthy.......mind over matter........may sound silly but at least it gives me something to "do".

 

That doesn't sound crazy at all. I think it's a good idea. I'm a firm believer in prayer and in body-mind medicine. I also believe that the two go hand in hand for best results. I've experienced great results with that method. I'll also will your little one to grow.

 

I agree with Meg... don't worry about TTTS until (if) you have to. TTTS is not diagnosed due to size difference between the babies. It is diagnosed by difference in fluid levels. If both of the fluid levels looked good, your babies do not have signs of TTTS. Really. So take a deep breath and relax (I mean that in a good way).

A size difference of less than a week at the stage you're at in your pregnancy is not an example of anything wrong. At 17 weeks, a baby is less than a pound. So you're talking the difference of an ounce or less between your two. That could be a true size difference or it could be due to inaccuracies in the ultrasound results.

As Meg mentioned, babies that are squished up in odd positions are notoriously hard to measure, so the measurement could be off by a bit. Also, there is an error factor in every ultrasound and that error factor increases as the experience of the technician decreases. You mentioned that you had only seen your family doctor not an OB. I would assume your family doctor's US tech isn't an expert on twins, so it's very possible that the measurements are slightly flawed as a result. Until you get into see your OB or even a Perinatologist, don't worry about the size difference! It may not even exist.

One final thing to say... even if there is a size difference in your twins, that doesn't mean there's a problem. My mono/di daughters were born with almost a full pound difference. One had a cord that attached closer to the edge of the placenta so she received fewer nutrients than her sister. They were both completely healthy and had no problems related to the size difference. So really, don't stress! Stress is much worse for your babies than the possibility of a small size difference.

Good luck!

ETA my experience.

 

I just wanted to chime in my experience. We had severe sac size differences and were told several times that our twin-b wouldn't make it more than a few weeks. That was 7 weeks ago and thanks to the Boost, the rest, prayer, and mind-body guided imagery, the sac sizes are now balanced out and both babies measure the same.

Keep up whatever you're doing. It's all sure to help and you'll feel good knowing that you are empowered to do something. It's too frustrating just waiting for doctors to figure it out.

The others are right, it could also be that the ultrasound didn't get the measurements right. It is difficult at times to get a good view of each baby. I agree that you should try to get an ultrasound done by a perinatologist. If you express your concerns to your doctor, there is more of a chance you'll get it soon. The doctor's job includes helping you to keep your stress levels down and if giving you a proper u/s will give you peace of mind, then that's worth it.

 

I would try and get into an OB sooner rather than later since you are already 18 weeks and you need some specific guidance about your twin pregnancy. I think they can best put your mind at ease and you can get your questions answered.

 

I'm surprised you aren't seeing an OB until you are 21 wks???
That is late I think even for a singleton pregnancy.

That said, I wouldn't worry about it until your doctors are worried. :hug99:

 

If you are really concerned about TTTS, go to the TTTS foundation website and ask the people there. Size discordance is not the only reason TTTS might be mentioned, but often it is the first clue.

I don't want to scare you - but here's what happened to us. at 16 weeks, noticed a one week difference in size of babies and we finally saw the membrane (yay!). We got referred to a peri to keep an eye out for TTTS. At 18 weeks, my donor baby had NO fluid and abnormal dopplers. The recipient baby had normal fluid and abnormal dopplers as well. I went on bedrest and boost drinks immediately, and at 22 weeks, all had evened out - we stayed even, with weekly monitoring until 38w4d.

Personally, I would want to be seen by an OB or peri sooner than three weeks. This is a criticial time if TTTS pops up - it can move quickly. They can do the surgery until 26 weeks and after that, they usually deliver if the TTTS gets bad.

But, many times, one of the symptoms/signs of TTTS is a size discordance, then the other things to look for are fluid levels, dopplers, bladders, hearts, hydrops, etc.

Go to the TTTS foundation site - do some research - contact Mary there, she will send you a bunch of information, and help you personally. She will also get you in touch with doctors that can help you, even talk to you on the phone without you being their patient.

PM me anytime.

Jenny

 

Like the others said, I wouldn't be worried about TTTS yet. It's just good to know the signs. Since you have mono/di twins you would be getting u/s at least every 2 weeks. Waiting to see an OB until 21 weeks is too long. If you had di/di twins, you wouldn't be as high risk but mono/di twins really should be watched closely.

 

Again, I agree with the others - you should be seeing an OB and getting ultrasounds at least every 3-4 weeks (preferably by a peri). Twins are high risk even if they are di/di. You should be getting your Level-II u/s between now and 22 weeks (preferably around 20 weeks).

I also agree that Mary at the TTTS Foundation (http://www.tttsfoundation.com) is a huge help. She's so sweet, understanding, and has personally helped so many people. She will help you now regardless of whether or not you have been diagnosed. She can give you coaching on how to get more information and proper medical care.