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Question for moms of MZ twins (or anyone in the know)

1K views 9 replies 9 participants last post by  laralou 
#1 ·
Hi there mamas,

We just found out yesterday who these babes are --
girl:
girl: -- and the tech said he was 99 percent sure they are MZ. We didn't find out they were twins til the 18 week ultrasound (i'm 26 weeks now), and each scan since then (we've had three total) has shown what looks like one placenta and a VERY thin membrane indicating two amnions. All three techs have said the membrane looks FAR too thin to be two fused placentas.

The good news is that there ARE two amnions... but if they are MZ twins, I know that we need to watch for TTTS and other issues. I can't remember the mama who had experienced this... but am just wondering what you did to monitor the babes and help keep them in there and as healthy as possible as long as possible. Were there warning signs or did you discover it with an US? I think at 30 weeks, my doc wants me going in for weekly NSTs and the tech said yesterday if the radiologist and my doc agree they are MZ, I'll be coming in every five days for scans starting at 30 weeks??? Does that sound right?

Also, the tech estimated yesterday that Twin B weighs about 890 grams (almost 2 pounds) and Twin A weighs about 800 grams (1.75 pounds.) I know US measurements are notoriusly off... but does this difference in weight already indicate one might be getting more nutrition than the other??

Any advice, wisdom, insight you have is greatly appreciated. Thanks in advance for your help.

Lisa

____
Mama to DS (born June 02), wife to DH (married Sept. 95) and expecting TWINS in July 05
 
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#2 ·
Hi Lisa!!! Congratulations on your twin girls!!! How exciting!!

I have MZ girls too. (They are 9 mos now!!) They shared 1 placenta and each had their own amion. Thank goodness no TTTS for us. But they were monitored closely. Docs were 99% sure for us too that is was not 2 placentas fused together. We found out for sure once they were born and placenta was examined.

I can tell you my experience.

At 23w5d both Baby A and B were both 1lb4oz.

At 28w1d Baby A 2lbs5oz and Baby B 2lbs6oz.

At 32w5d Baby A 3lbs12oz and Baby B 3lbs14oz. There was concern at this u/s cause tech said there was a 10% difference in blood flow btwn babies. She sent me over to see specialist right then and he said all was well and that a 10% difference right now was fine and we'd just watch it.

At 33w5d Baby A 4lbs2oz and Baby B 4lbs8oz. At this one the doctor noted the difference in weights. He said it was a 8% diff and that it is nothing to worry about until it gets to a 25% diff at this point.

At 36w1d Baby A 4lbs13oz and Baby B 5lbs9oz. 14% difference in weights.

They were born then at 38w1d. Baby A 5lbs7oz and Baby B 5lbs12oz.

Also at 32 weeks I started NST on aver every week. Sometimes it was 1 1/2 wks and sometimes it was every 5 days. I didn't want to have them that often for fear of unnecessary intervention. Yet I also liked it
: so I could see my little ones and make sure their weights and blood flow were good and they were turning constantly and I wanted to see if they were breech or vertex as I couldn't always tell in my tunmmy. I was so afraid of them both being breech (since they were usually positioned like this) and not being able to have them vaginally.

Turned out that on my last NST Josephine hr was extremely low and they took babes c sec in 10 minutes before I ever knew it. Josie was fine when she came out so of course I can't help but think there was unnecessary medical intervention.
On the other hand what if something was wrong with her and they didn't get her out. Anyway, now I have 2 beautiful healthy girls!


The things I did to help prevent problems was to eats tons of good stuff and tons of protein and drink tons of water and try (this part was hard with a baby to run after) to rest. Did this prevent TTTS? I have no idea. I'm sure mamas out there that have expereinced TTTS can give you much info.

Anyway congrats on your girlies!! Mine have been such a joy and I'm so happy for you!!!
By the way my girls even now are head to head with their weights. They are exactly the same weight right now.
 
#3 ·
First, congratulations Lisa.

Second, I just have to say (with the risk of sounding annoying), please relax and don't stress too much about this. I know exactly what you're going through and I remember how stressful it was.

My girls were monochorionic/diamniotic. We knew that from early on--I think around 14 weeks or so, when I was assigned a perinatologist. My OB didn't think there was a membrane separating them at all, but the perinatologist found it (thankfully!). From the very beginning it was really hard to find the membrane every single time I had an ultrasound (and I had many).

The timeline is hazy to me, but I think I started going in for weekly NSTs at 28 weeks. At one of my NSTs the fluid on Baby B was low, so they kept me in the hospital for the day to monitor me, but it turned out to be a false alarm. I don't remember what the exact weight measurements were, but there was always about .25 to .5 lbs. difference between them.

I had a really awesome peri--she was very good but very cautious with me (I also had placenta previa, gestational diabetes, early contractions so I was in there a LOT
) and she decided around 30 weeks that she wanted me to come in for NSTs twice a week. When I was 32 weeks pregnant, Baby B (who had dropped down and was in the position of Baby A, but then never renamed them--talk about confusing! :LOL) was jumping on her cord. I was put in the hospital for good then & had to deliver them 6 days later due to her prolapsed cord.

Thankfully we dodged the TTTS bullet and I have two healthy, happy, non-stop 18 month old girls. I do remember their weights being quite a bit different from what they said they were going to be (again, the details are hazy--it was a crazy time). Baby #1 (but she was still Baby B) was 4 lbs. 3.8 oz. and 17 1/2 inches long. Baby #2 (Baby A) was 4 lbs. 12 oz. and 19 inches long. Baby #1 was always quite a bit paler than her sister when they were preemies, and some have said that that is an indication that some TTTS occurred, but I don't know that for certain.

Even now there's still about 1 lb. difference between them and one is about 1/2 inch taller than the other.

Good luck. Enjoy this time, seriously. I know it sounds kind of sick, but whenever I drive by the hospital where I delivered (& where my peri was), I kind of get wistful. I know it's not popular to say that heavily medicalized (is that a word?
) pregnancies can be a good thing around MDC, but in my case I'm absolutely convinced that it saved my daughters' lives.
 
#4 ·
Congrats on your twin girls! Mine just turned 2 & they're alot of fun


From alot of the reading I've done, it's essentially impossible to determine w/ 100% certainty that a placenta is one big one or two fused ones & my ob refused to even try (just left it that we don't know if they're mz or dz. We later had a dna test done that came back as 99.99% certain they're mz). I don't have any personal experience with TTTS but from discussions about it on the apmultiples yahoo group, I gather that there's really nothing that can be done to prevent it & u/s is the easiest, earliest way to detect it. I found out about my twins at the 20 wk u/s and at that point had to switch from the midwives/birth center I'd been using to an ob practice (& hospital delivery of course) the ob had an u/s machine in their office so I got a quick u/s to check weights/sizes at every appointment thereafter. I don't remember my exact appointment schedule, I think it was slightly "ahead" of a singleton's (in otherwords, started being bi-weekly & then weekly sooner than it would have w/ a singleton) but not by much. That was the only additional monitoring they did for TTTS was the u/s at each appointment. At one of my last appointments the babies were measuring farther apart then they had been. The dr. was almost certain that it was just a bad measurement (by that time - 34 weeks, there was so much baby crammed in there that it could be very difficult to get accurate measurements) but just to be sure he sent me to a place w/ a fancier u/s machine. They measured them closer together & 2 days later (at 35 1/2 weeks) I delivered them at 5lb 11 oz & 5 lb 2 oz (but the smaller one had less "preemie issues" so I'm pretty sure there was no problem w/ their size diff).

HTH
 
#5 ·
My boys have TTTS, and I know there are at least 2 other folks that read this board who had to deal with TTTS as well.

The TTTS in our case was detected at the first level 2 ultrasound (I think at 16 weeks). So we never went into a monitoring FOR it pattern--it was keeping very close tabs on any changes and being prepared to fly down to FL for the laser surgery as soon as things got bad enough to qualify. (Fortunately for us, although we were in the grey area, we never had to do that).

U/S detects it earlier, but there are warning signs that you should never ignore. If you wake up one morning (or notice over a space of a day) that you are growing exponentially and it feels abnormal to you, or you have pain while that's going on, you need to be seen ASAP. One of the side effects of TTTS is an increase in amniotic fluid for the "recipient", and if it kicks into overdrive, you will notice! (Overproduction of amniotic fluid can happen with singletons too, and it can be serious for them as well, so anyone should be seen when there is pain with really rapid growth)

More later, toddler crying.
 
#6 ·
Thanks, mamas, for your good insight and encouragement. It means so much to me.

I know we can't know for sure about MZ or DZ status until after they come since we didn't know they were twins til almost 19 weeks, but this last U/S was the first time they saw the sex clearly, and between seeing two girls and the fact that each time they've had such a hard time seeing the membrane... I think my OB will be keeping a closer eye on things just in case.

Mamadawg -- it's interesting what you said about a having a heavily medicalized birth and so encouraing to hear all the good that can come of it... it was one of the first thoughts I had when we learned they were twins. I'm trying to make my peace with all the people now involved -- to read and understand as much as possible about what is necessary for ensuring the health of the babes and what is the medical world just being the medical world...

Having you all here makes such a difference. Thanks!
I'll keep you posted...

Lisa
 
#7 ·
hey!
i haven't been here in AGES, but wanted to chime in --

my girls are 15mos old and we did have TTTS; early US @ 10w showed monoamniotic, and a membrane was later found at 16w when we were also diagnosed with the TTTS. Nutshell: I did EXTREME PROTEIN therapy & narrowly avoided voluntary laser surgery; the girls' fluids and growth evened out for 12 weeks or so (which was monitored through weekly US for fluid & biweekly for growth & heart problems) and then at 30w, their sizes started to shift a little bit, and by the time I was induced at 34w when Baby B had seemed to stop growing, they were 4lbs. 12oz., and 3lbs. 4oz.

Reading now, it sounds like I have a lot in common w/ Tigerchild!

Anyway, for me I kept tabs on how my belly felt - like, how it felt to me by palpating it. Increased fluid was always noticeable, not only because I felt suddenly bigger, but also, there was a weird soreness. (I'm also a massage therapist, and I don't know if that makes me more sensitive to feel stuff like that?) There were times in the AM when I would get up and my husband's eyes would pop because my belly had grown...it was truly bizarre.

I don't remember when I started NSTs, but it was probably in the late 20s and I went 2x/weekly in addition to the weekly U/S. I'm no medical professional, of course, but the 5 day scans sound a little much unless there are noticeable changes in size discordance, but... I don't know. Despite my love of all things Natural & Birthy, when I do re-reads of all the TTTS stuff & possible complications of when it either comes back or just rears its head at the end of pregnancy...well, definitely, I would play it safe.

Best of luck to you, and congratulations!

If you want to chat w/ me, feel free - my email is at yahoo.com and it is the same as my username here!

kathy
 
#8 ·
Quote:

Originally Posted by LoisLane
I know we can't know for sure about MZ or DZ status until after they come since we didn't know they were twins til almost 19 weeks, but this last U/S was the first time they saw the sex clearly, and between seeing two girls and the fact that each time they've had such a hard time seeing the membrane... I think my OB will be keeping a closer eye on things just in case.
My girls are MZ but were dichorionic/diamniotic. We had to have their DNA tested after they were born to determine their zygosity. Because of them being di/di we didn't face the TTTS issue so I don't have any words of wisdom for you in that area. I just wanted to chime in with my 2 cents on determining their zygosity. Be sure your OB carefully examines the placenta/placentas after they are born to see if they were one or two that fused. Also, have their blood typed. If they have different blood types then they are DZ for sure. If they have the same type then you may have to have their DNA tested to be sure. Congrats on your girls!!! Any name ideas yet?!

Edited to add: Forgot to say not to go by looks alone that they are DZ or MZ. My girls looked TOTALLY different at birth but over the first couple of months started looking much more alike.
 
#9 ·
Hi, My twins had TTTS also. Although it was less severe than a lot of people, they were 25% different at birth. One was 6lb 3oz the other 8lb 5oz. They were also dichorionic and diamniotic. Very rare with boys, I hear. One ginormous placenta! I went 38 weeks before being induced.

They are almost 7 now and one is still about 1lb more and the other is taller. They have lots of differences for identicals. So much so, that most people don't think they are identical. They were tested as newborns however.

I went on to have a singleton three years after the twins and had complications with her as a direct result of the twin pregnancy on my body. I started with a subchorionic hematoma because of scarring from the twin pregnancy. Anywho, all of them are fine now.

I live in Tampa Bay, luckily, the Doc that does the enutero surgery for TTTS is here as well. I did not feel anxious about TTTS during the pregnancy mostly because of that. I did contact the TTTS foundation, but my boys have so little impact from it that I felt that it wasn't necessary for us. There were many others with so many other issues.
 
#10 ·
They were always off on measurements with my MZ diamniotic twins. They measured Tristyn as so much smaller than her sister throughout the whole pregnancy. Well, I am pretty sure that they just never got good measurements on her because she weighed 3 oz more than her sister at birth. (I know that doesn't seem like a lot but it was huge to my eyes- at least I couldn't get them confused)
 
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