TWIN BOYS

Sunday, November 10, 2013

So Much to Worry About

Being pregnant with twins has a lot more than just the physical problems that are experienced.  I have learned so much in the past 4 1/2 weeks of my pregnancy.  I am now 24 weeks and 6 days pregnant.  Here is a little about what I have learned and a little about my story.


At my 20 week ultrasound they found a 25% difference in weights in the babies.  Greater than 20% is of concern.  I have been being watched closely for TTTS syndrome (twin to twin transfusion syndrome) which is only seen in mono/di twins (identical, one placenta with a thin membrane separating them).  Having a big difference in the weights is a precursor sign of TTTS. 

A little about TTTS syndrome.  There are 4 stages of it.  The first two there is just a significant difference in the amniotic fluid around each baby, one having too much and one having not enough.  The babies start to be classified as “donor” and “recipitent”.  Also, the second stage the bladder does not show up on the donor twin.  These two stages are watched even closer and strict bed rest is ordered.  The next two stages are more involved with the blood flow to each baby and if discovered before 25-26 weeks laser surgery is done asap.  The nearest places that do this are St. Louis and Houston.  If this surgery is done there is only a 60% chance both babies survive and an 80% chance only one will survive.  So as you can see, it can be super scary to get diagnosed with this.  The risk never fully goes away of getting TTTS, the treatment just changes.  If the fluids around each baby is too off, then amnioreduction (needle insertion to withdraw fluid around baby), is done and it is usually not a one time thing.  (kind of a side note, I joined a ttts fb group and came across a friend from high school who is just going through it.  She had to have the surgery, but one of the babies died at 20weeks, now she is waiting to deliver anytime and will deliver one healthy baby and one dead baby…..brings all this to reality)

So each week is very intense going in to the MFM specialist to make sure that I won’t be classified in the TTTS category.  This past week was a relief, but also a stress since the babies measured 26% difference.  Usually there are 4 reasons why babies have that big of a difference who are mono/di twins.  TTTS, blood vessels, cord not fully attached and the most probable for me is a difference in placental share.  A difference in placental share is the best, but also worrisome.  The difference will probably get worse and depending on what it does and how much the smaller baby grows will determine how early the twins will be delivered.  The bigger the gap gets, the sooner they will be born.  My doctors have said that there isn’t much I can do.  Both TTTS and the placental share are really determined as the egg splits in the early days of conception.  It’s all about how much nutrients go to each cord.  I’ve done a lot of research and talked to some people that have dedicated their lives to helping woman in this situation and I’m finding that horizontal bed rest and high protein drinks 3 times a day have shown to help.  I do this the best that I can at this point.  

I have really been stressed over everything and hope each week when I go for my ultrasound that everything is ok.  I am growing larger by the day and my body is showing signs of weakening daily.  I can tell this isn't my first pregnancy either, but my 5th.  

We are very excited though that we are having twin boys!  We just hope and pray daily that I will be able to carry the babies to term and that they will be healthy.  I also pray that they will have equal amounts of fluid and blood flow to each baby and get nutrients that are needed.  After the 20 week ultrasound everyone was so excited to know what the babies are, but the main concern for me was that we were now experiencing a high risk pregnancy and there could be potential problems.  It was a very hard day and no one else even asked if the babies were ok, it was all about if they were boys or girls.  At that point it didn't matter.  All that mattered was the fact that things could be scary.  

I go in tomorrow for another growth scan to measure their progress.  I am so nervous going in for the appts and relieved when they are done with when we get good news.  

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