I am new to these boards - and just started browsing through threads.
I have 1yr old twins that were born in a hospital (vag, med-free, low-intervention). My OB didn't *know* a lot about chorionicity, but since my research after the babies - I believe that my twins were diamniotic / monochorionic. First ultrasound was at 8wks, babies look like they were in one "big black circle" (chorionic sac) but had the thin membrane separating them (amniotic). When born, the placenta came out as one - but they neglected to have it tested...so we don't know 100% if it was indeed one, or fused (I believe it was one because of 1st ultrasound and the following info). Now that I got all that out of the way - I wanted to share my story with you regarding possible Acute TTTS.
Originally Posted by Tigerchild
I suppose it's true on a fine point that TTT doesn't 'develop' during delivery (and thus, you wouldn't have the syndrome bit). But the complications can, rarely, if those connections are there or have the potential to cause one twin to donate blood to the other through the placenta.
Pregnancy & delivery was great - free of complications. Labor was fast (5 hrs), but I suspected it would be - my first was only 7 hours. Got to the hospital and was 7cm. Was monitored off and on, but I took the "belts" off often to go to the bathroom (claimed I was peeing but really to labor away from nurses). When I started bearing down they wheeled me to the OR to birth the babies. I can't remember if they monitored them at this point, I'm sure they probably did but I'll have to watch the video or ask DH....anyway...Baby A was born and was very lethargic and white. They cut A's cord right-away. I held on to him while I started pushing B out (they were 7 minutes apart). When they took A's blood pressure, it was different between his arm & leg (and low). They suspected a heart defect. Oh - birth weight was only 2oz difference. To make a long story short - after taking Baby A to a NICU and running various tests, his hemoglobin was low, they came back and tested Baby B's hemoglobin and it was high. Soooo...they diagnosed them with Acute TTTS. I had no symptoms during pregnancy, and even during labor the babies showed no signs of distress.
Thankfully it was a fast labor - I don't want to imagine what could have happened.
I wish I would have kept better track of the placenta, but I was told it was going to the pathologist for testing. When at 8 weeks post-partum I didn't get any reports on it I tried tracking it down....and did not succeed. So, technically, we don't know for-sure if they had Acute TTTS, but I have tried to do research to find other reasons why Baby A's hemoglobin would be high and B's low and have not come up with anything (yet) other than Baby A was the donor and B was the recipient.
So, I know this veered off homebirth and Chorionicity, but the poster that said that TTTS is not acute - I just wanted to reinstate that is not true. Although it is rare, it is something to consider when choosing to have identical twins at home vs. the hospital. However, what would they have done to help me deliver faster? My babies showed no signs of distress...if it was Acute TTTS, then it kicked in at the very end of my labor**** - and they were born fast so I don't think having them at the hospital made it any safer for this particular situation.
****from what I understand - Acute TTTS lays dormant until labor begins and at some point the contractions and mother's change in blood pressure kicks it into gear. Obviously, the blood vessels were formed when the placenta formed, but distribute blood correctly until some point in labor.
Sorry about the novel!