How possible is it to miss a twin at a 20 week ultrasound?? - Mothering Forums

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#1 of 16 Old 08-05-2009, 04:43 PM - Thread Starter
 
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At my OB appt yesterday we found two heartbeats. I'm almost 33 weeks!! It's not possible, right???

This baby has been confusing to me, sometimes feels like he's an octopus, and he's SO active, I've been having trouble identifying his body parts and his position. I'm pretty sure he's breech with his head under my right ribs (there's an obvious "lump" there), so I asked yesterday at my appt. His heartbeat was found just above and to the right of my belly button, strong and sounded like a "gallop". But as the NP was palpating, she found another "lump" down very low and said "but that feels like a head" and she put the doppler down there and found ANOTHER "gallopy" heartbeat.

Now, my midwife has found that lower heartbeat before, but it's always been "swishy" and she's always said it's the cord. This is the first time that the lower heart beat has sounded "gallopy". The rate was about the same for both, in the 150s.

I had suspected twin losses with my other two pregnancies (one had an abnormally high HcG with lots of bleeding, an enlarged uterus, but never another fetus seen; and the other had a second yolk sac that never developed into anything) and there's a strong family history of twins (although we're one of those families that seems to break the "rule" because all the twins are identical, not fraternal)

I had twin suspicions early on with this pregnancy again...I showed very early, I could palpate my fundus very early, and the "octopus-like" feeling plus the big increase in movement is different for me. But I've also had two ultrasounds...one was at 12 weeks and was just a quickie because they coudln't find a heartbeat (so I could see how a twin could have been missed then) but my second ultrasound was at 20 weeks and was very thorough because my younger son has a genetic syndrome so we were specifically looking for markers.

They couldn't possibly have missed a baby BOTH times??? Right?

My fundus is measuring just a bit big, but it did the other two times and I had two LGA babies.

I've gained more weight than my second pregnancy, but less than my first.

I've actually been LESS sick this time, although the physical discomforts have been more (back, hip, and pelvic pain).

I'm almost positive that there can't be another baby hiding in there all this time, but I also can't explain the second heartbeat. The NP didn't seem all that concerned, said to ask the OB when I see him at my next appt, but that isn't until 36 weeks. I'll go see my midwife again and we'll try to find both heartbeats on two dopplers if we can (will they interfere with each other?) to see if it's the same heartbeat or truly two.

Any thoughts??

Mommy to BigBoy Ian (3-17-05) ; LittleBoy Connor (3-3-07) (DiGeorge/VCFS):; BabyBoy Gavin (10-3-09) x3 AngelBaby (1-7-06)
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#2 of 16 Old 08-05-2009, 04:49 PM
 
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Whoah. I can't imagine they could miss another baby with the Level II, but who knows. I'd probably ask for another ultrasound to put your mind at ease.

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#3 of 16 Old 08-05-2009, 05:02 PM
 
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Originally Posted by Katielady View Post
Whoah. I can't imagine they could miss another baby with the Level II, but who knows. I'd probably ask for another ultrasound to put your mind at ease.
I agree.

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#4 of 16 Old 08-05-2009, 05:35 PM
 
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I think it would be hard to miss at 20 weeks. By that time both babies were so big, they were moving all over and you could often see parts of both babies on the screen at the same time. At my 12/13w US you could often see both babies 'bumping' into each other, and I have pics of them each as individuals, but there will be a few spare parts in the pics from the other twin. At my Dr appt.s they would use two dopplers so that they made sure they had each baby on a different doppler, they would turn the sounds up and make sure they went up/down at different times b/c they can echo across the womb.
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#5 of 16 Old 08-05-2009, 07:17 PM
 
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I was thinking more about this (you know, instead of doing diaper laundry ) and I remember a midwife once telling me that a client of hers had been told by several doctors after several ultrasounds, including a level II, that her baby had one arm and no nose. The poor mother of course stressed the whole pregnancy. Then the baby was born and was perfectly healthy and normal- nose, two arms, and all.

So maybe if they could make that kind of mistake, they could miss another baby.

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#6 of 16 Old 08-05-2009, 07:34 PM
 
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I think it would be very difficult to miss a second baby at 12 weeks or at 20. I had a US at 10 weeks (specifically looking for 2 babies because I was measuring big), and it was very obvious that there were 2 in there - not very big, but definitely two.

At 20 weeks it was hard to keep track of which limbs belonged to which baby, and when I made that comment, the US tech told me that he had examined a woman pg with triplets that morning - twins were a breeze. I glared at him and said "You make sure there isn't a third one hiding in there!!" He glared right back and said "I'd stake my career on it!".

This was 15 years ago, and the technology has no doubt improved since then. I would have a lot more confidence in the US than the Doppler.

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#7 of 16 Old 08-05-2009, 08:01 PM
 
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I have a friend that had surprise twins at birth. She had a 12 wk, 20 wk and about 32 wk US. The Dr was known for his thorough care and shocked by the second baby. He went back to check to US's again and proclaimed he could find nothing to indicate 2 babies. Except that Mama was huge. It happens.

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#8 of 16 Old 08-05-2009, 08:45 PM - Thread Starter
 
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Ok, all of you were making me feel better, except MamaMem!!!

It's got to be cord or placenta...must be...I mean not only did we not see two babies on either ultrasound, but I'm also not *huge*. I'm big, yes, but I've been big in all my pregnancies, and I delivered both boys at 38 weeks, weighing 9.5 and 8.5 pounds. So I just assumed I'd have another big baby, which is why I showed early and am slightly bigger.

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#9 of 16 Old 08-06-2009, 12:01 AM
 
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Mine were both quite active, and moved all over the place, including sometimes hiding one behind the other. In every ultrasound it was really obvious that there was a 2nd baby. It would be pretty rare for them to not notice a twin if you'd had u/s at 12 and 20 weeks.

The other thing is that if the baby is moving, the heart rate can change very quickly, by like 20 bpm. If you use a doppler in one area and it's, for example, 118bpm and then move it to another area 5 seconds later and it's 142bpm, that can definitely be the same baby. The doppler can pick up the heartbeat in several spots, but it is just an echo and not a second baby. Trust me, because I had to have monitoring countless times, and got very good at finding their heartbeats with the little monitors, watching them fluctuate rapidly, and figuring out what was an echo and what was a real heatbeat!

If I were you and had your history, though, I'd be getting another ultrasound just to make sure. If it's twins you'll need to be able to plan ahead!
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#10 of 16 Old 08-06-2009, 08:23 AM
 
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I'd get another u/s. The placenta would pulse at a much slower rate than 150. I think it pulses at the maternal heart rate if I'm remembering correctly.

Wow, keep us posted!

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#11 of 16 Old 08-06-2009, 11:48 AM
 
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it's so, so unlikely that i wouldn't waste energy on it, but it's horrible when this kind of thing happens. i feel like she shouldn't have mentioned it unless she has a plan for how you're supposed to follow up on the idea, kwim?

generally it's only an ultrasound that can confirm during preg that there is more than one baby. movement, size, shape, heartbeats etc etc...we hear so many stories where we would not have picked up twins or where ppl have misdiagnosed them on these points alone.

there are always exceptions, but they are generally not very helpful psychologically when you're unsure what's happening in your uterus so i'd say stick to what the ultrasound shows and enjoy a surprise baby if he/she turns up on the day

anyway, let us know mama......

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#12 of 16 Old 08-06-2009, 06:21 PM
 
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I'm only lurking in this forum as a "twin hopeful," my maternal grandmother had four sets and my only female maternal cousin had one set, so why not me??? But... not me.

Anyway, it's often easy to pick up one baby's heartbeat in two opposite places. As in, top left AND bottom right. I believe it's because you can hear the heartbeat through the back as well as through the chest.

However it sounds likely that you could be carrying twins given your past history, so I would definitely ask for another u/s!

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#13 of 16 Old 08-06-2009, 09:50 PM
 
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In my experience even an early U/S is pretty obvious, even if it is quick. I had one done at 9 wks because I suspected twins and the moment he laid the U/S thingy on my tummy we saw them both. There was absolutely no question. Then he spent a few minutes looking around for #3.

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#14 of 16 Old 08-07-2009, 12:27 PM
 
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Until very recently I would have said this was crazy and there was no way that modern U/S could miss a second baby, but I've actually heard about two cases in the past couple of weeks where the babies were just positioned such that they missed the second one. Sorry to add to the uncertainty! Honestly, my singleton was extremely active and it's only when both kids are active at the same time (and only sometimes at that) that this twin pregnancy feels any different...aside from the fact that I'm huge of course! My baby A is so low and sort of behind his sister that now at 39 weeks I only feel him when he has the hiccups or pokes his feet into my ribs. Baby B on the other hand, feels like an octopus all on her own sometimes! Also, from personal experience, it's definitely possible to pick up the same baby's heartbeat in two places and at similar strengths...my NST nurse just did it the other day while "looking" for Baby B!
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#15 of 16 Old 08-09-2009, 12:01 AM
 
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I think a lot of it has to do with the breech position. My baby was breech much of the pregnancy and really threw my experienced midwife off. At about 32/33 weeks, she thought she was hearing 2 heartbeats and sent me for an ultrasound. I had to wait a whole week to get an appointment! That whole time, I couldn't believe that I could have an extra baby along for the ride without my body or my mind knowing it on some level. Turns out I didn't. Just one very breech baby. The Ob-gyn said it's common to hear 2nd heartbeats with breech babies because of their odd positioning.
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#16 of 16 Old 08-09-2009, 03:03 PM
 
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I bet it was an echo, which happens a lot.

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