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Homebirth and Chorionicity - Page 2

post #21 of 27
Butterfly, you can always email Dr. De Lia, he is the country's leading TTTS expert. Google "Julian De Lia TTTS" and you should get to his site. I had a friend who actually lost one twin just after birth, and she didn't discover until months later (after talking to her doc and Dr. De Lia) that it was TTTS.
post #22 of 27
YumaDoula - Thank you for your response and recommendation. However, at this point I think it would be wasting his time to try and contact him. I don't think he could tell me anything without a placenta to test - I'm thinking we can only assume at this point. If we do the DNA test (we haven't had the money) and it comes back that they are identical - then we can just be a little more positive that it was acute TTTS. My mama instincts (and from the first ultrasound) I think they are identical and from the researching I've done I'm guessing that it was, indeed, acute TTTS.

I am so sorry that your friend lost one of her twins. I hope that peace has come to her and her family. Did it happen during the pregnancy or during birth? How did contacting Dr. Julian De Lia help her determine it was TTTS? Did he do some testing? Just curious. Thanks.
post #23 of 27
Okay - I'm sorry about serial posting!! I've read through all the posts again and I get what JenPL is saying about TTTS not being acute, and I even said something along those lines:

****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.

Because of the fact that when the placenta is formed that's when the blood vessels are formed and distributed....this would be something that "started" from the beginning - ie: chronic. But - they probably just wanted to label this type of TTTS acute because everything is fine until the end. I hope that makes sense.

Also - Renesis - I wanted to clarify something for you from your first post (I don't think anyone has said anything about this yet).

It appears that they are sharing a placenta but are separated by a thin band in the amnion, so two amnions. However, the ultrasound did not determine if they share a chorion.

If they share a placenta then they share a chorion. The placenta is formed within the chorion sac - so di/mono twins will always share a placenta (and obviously mono/monos share a placenta - di/di have their own). I had a really good article about determining chorionicty via ultrasound, I'll see if I can dig it up for you. ETA: here it is:

http://jdm.sagepub.com/cgi/reprint/22/1/59.pdf

I know this thread was started a while ago - so how are you doing? I would love to hear an update and any decisions you've made regarding the birth!
post #24 of 27
Thread Starter 
Thanks for getting back to me. The reading I've been doing and the info. my midwife gave me said that the appearance of one placenta doesn't always mean one chorion since two placentas can fuse and appear as one. The article you sent was a good one and it does say that you can have either two or one placentas and still have two or one chorions. Bloody confusing, eh? Unfortunately, the ultrasounds we have had have not been diagnostic enough so we are being considered monochorionic "just in case". Both babes are growing identically and are the exact size they should be. The pregnancy has been going well. Zero signs of preterm labor, I have a "giraffe long" cervix, apparently, and no complications. I have been attending a special clinic for multiple pregnancies in addition to my midwife, but my husband and I have decided to reduce the number of visits to the special clinic. I am not pleased with their policies and overuse of ultrasounds. I walk out of there feeling that I am only the "vessel" carrying the babies they are so interested in. They don't even check my blood pressure! It definitely gives me a sense that they feel their practice can take better care of my babes than my own body. Not a belief I agree with and not a feeling I get from my excellent midwife. Baby A is currently vertex and Baby B is breech - we are 23+3 weeks in. As long as both babes are vertex by the time I go into labor, we are still planning a homebirth. Keep your fingers crossed for me.
post #25 of 27
Quote:
Originally Posted by Renesis View Post
the appearance of one placenta doesn't always mean one chorion since two placentas can fuse and appear as one. .
Oh, yes - you are absolutely right. I meant that if it is truly one placenta then it will be one chorionic sac. But as you know, there is no way to be 100% for sure that it is one placenta via ultrasound. But then again, according to that article, you can sometimes tell if you have the ultrasound early enough and have someone who knows what they are looking for/at.

Quote:
Originally Posted by Renesis View Post
The article you sent was a good one and it does say that you can have either two or one placentas and still have two or one chorions. .
I'm not sure what you are meaning here - it's been a while since I've read this article. I'll print it and re-read it so I can understand. From what I understand - if there is one chorionic sac then your babies will have one placenta. If there is two chorionic sacs then they will have two placentas.

Quote:
Originally Posted by Renesis View Post
Bloody confusing, eh? .
Most definitely!! I've been trying to read as much as I can on the topic for over a year now and I can still get confused, but I *think* I have it down for the most part :

If you don't mind me asking, why have you been going to the special clinic? If you and your Dh don't feel comfortable with them, and have an excellent midwife, why not stop your visits to the clinic all together? This may reduce the stress on you and could possibly help you avoid any fear that may come with simply walking into the clinic. I am certainly keeping my fingers crossed for you!! I love hearing twin homebirth stories - I hope you join that "club"
post #26 of 27
Thread Starter 
We have been going to the clinic to "cover our bases" so to speak. Our midwife recommended we have it down on paper that we did some of the "traditional" steps to rule out issues but she is encouraging us to do what we feel is right at this point. She's not a fan of how they are treating us either. We really wanted them to tell us the chorionicity and they couldn't even do that!
post #27 of 27
[QUOTE=butterflybluz;6846040]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.


QUOTE]

Your situation sounds VERY similar to mine. Have you heard of Dr. De Lia? He is an expert on TTTS. His contact info is here:
http://www.twinhope.org/centers_us.html

I spoke to him several times after my girls were born in April. My girls were born at home, no complications, nothing starnge. They both weighed the exact same weight at birth. Baby A was anemic and Baby B was polycythemic. They both showed signs of TTTS. I sent Dr. De Lia pictures of my placenta and even had it examined. His opinion was that my girls developed TTTS during labor. They are both 100% fine now and had no complications. But, as you know, TTTS can develop at term or during delivery. It sounds like the same thing happened to you. I did not even know it was possible until after my girls were born.
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