mono/di vaginal delivery stories...good ones? - Mothering Forums

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#1 of 12 Old 04-27-2007, 12:34 AM - Thread Starter
 
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For those of you who have had monochorionic twins, can you please share some good stories of vaginal births? I haven't posted much on this board, but have gotten some good advice when I did post and I was hoping you all could give some encouragement. We lost twins last year to TTTS at 23 weeks, and 4 months later found ourselves pregnant with mono/di twins again! Anyway, I'm 35 weeks now and both girls are head down, so our Dr. says it's a "go" for vaginal delivery. There haven't been any signs of TTTS at this point, but I know acute TTTS can happen at delivery, though it's rare. I've just heard it's a risky thing to deliver mono/di twins vaginally and I just want to hear from others who have done so with good outcomes/experiences.

How much time was there in between the babies' coming out? Did you have an epidural? Any details would be helpful.

Thanks so much!

Melissa
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#2 of 12 Old 04-27-2007, 01:02 AM
 
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I am sorry about your loss, and send you congratulations on making it to 35 weeks and this healthy pregnancy!!

Here's a happy mono/di vaginal birth story for you! Seven minutes between babes. Twin A was vertex and easy to push out. Twin B presented with two feet and a fist -- my OB tucked her hand back in and held on to her ankles while I pushed her out. I don't know why vag. delivery with mono-di would have any more risk than any other twin birth with two amniotic sacs... the chance for acute TTTS is quite slim, I think...

I ended up with an epidural (at my request -- but it had more to do with my mental state than any physical thing or twin thing -- I kind of freaked out at 4 cm, which is where I had a hard time with my labor with my son). It was a VERY light epidural -- I was still able to walk around and told the nurses when it was time to push, and felt very much in control when it came time to push. My OB did not insist on an epidural -- he said if it came to a place where an emerg. c/s was needed, it would be a true emergency and not enough time to reup the epi to do the c/s -- he'd go straight to general.

There are a lot of wonderful birth stories on a sticky, I think, and lots of mamas here with mono-di twins. Good luck these last weeks!!! Keep us posted!!!
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#3 of 12 Old 04-27-2007, 02:08 AM
 
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Most likely any issues that would come up due to TTTS at the delivery would be caught by monitoring. My Perinatologist has said to me that the further along you are when the TTTS appears the less severe it tends to be. I'd try not to worry too much about it. Mine are mono/di as well and I've been told then should they develop TTTS then we can still attempt a vaginal delivery if they are in good presentation. If the risk of it getting more severe in delivery were an issue I doubt she'd have agreed to it in the first place. Obviously if they get very distressed or are in danger I'd get a c-section, but I'm pretty confident i'll have a normal vaginal delivery. Hope everything goes beautifully for your babies arrival

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#4 of 12 Old 04-27-2007, 11:34 AM
 
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I birthed chronic TTTS mono/di twin boys 4+ years ago. I can't believe how fast the time has gone!

Okay if you search for any topic on TTTS on this forum you'll find a longer version but here's a very short version. Baby A came out head first. Baby B came out feet first. No problem. 8h labor. They were about 10m apart. I think I might have ended up with a c-s for B but his foot just slid out, so they just screamed at me to push, ya know?

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#5 of 12 Old 04-27-2007, 12:58 PM - Thread Starter
 
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For those that have responded, thank you so much! Also, how far along were you when you delivered? Thanks!

Melissa
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#6 of 12 Old 04-27-2007, 02:01 PM
 
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34w, the TTTS was getting pretty severe for baby A at that point, so I agreed to an induction.

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#7 of 12 Old 04-27-2007, 02:23 PM
 
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started labor at 36wk6 days and gave birth at 37 weeks.
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#8 of 12 Old 04-28-2007, 02:31 AM
 
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Yay! Thanks for asking for GOOD stories (and thanks for believing they are out there). I was monitored for TTTS throughout the pregnancy. Scary weeks around 22-24 weeks when suddenly a sig. growth dispcrepency but fluids were good in both sacs and the growth discrepency then minimized.

All natural delivery at 39 wks 4 days. Twin A vertex. 3 hours and 10 minutes from first contraction waking me up until he was born (but first 40 minutes of labour had been so slight I was really questioning whether this was "it" - and I had done labour/birth 3 times before!). 17-minute interval (no pit. etc). Twin B double-footling breech. We decided after all research that this was a safer option than c-section, external version, internal version, or breech extraction. All wonderful. Slid out quickly in two "fetal-expulsion" contractions. Born in the caul. Cried immediately when the sac broke open.

Only complication was small persistent area of uterus which wouldn't firm up with 45 minutes of uterine massage (I initially refused pit/syntocinon). So ended up with Syntocinon and Hemabate but all responded well.

The bad part of the pregnancy and delivery was all the scare tactics and intimidation from the doctors. Despite an embarassing lack of objective pertinent evidence, prenatal doc and delivery doc (ended up being different) both advocated a lot of interventions and were extremely put out that we didn't agree.

I also thought deeply about acute TTTS, especially as we approached term and seemed to have evaded chronic TTTS. Of note, from what I read, a c-section doesn't PREVENT acute TTTS from occuring. It was simply that if it DID occur, they then have the second babe out immediately and can move on to further action. However, we decided that the small risk of acute TTTS was not worth the well-documented and more-common complications of c-section.

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#9 of 12 Old 04-28-2007, 01:05 PM - Thread Starter
 
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Thanks so much, Manitobamom!! It sure does give me more hope about delivery without complications!
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#10 of 12 Old 04-30-2007, 10:41 AM
 
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I was induced at 38 weeks (HBP), but no epidural or pain meds. Had them vaginally after my water was broken an hour later and 4 min apart. I believe they had slight TTTs one was 7 lbs and the other 5 lbs 8 oz. But everything went great (we had to work through some acid reflux and apnea at first). But babies thrived with breastfeeding and now 3 years old. Good luck to you, sounds like everything is going great
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#11 of 12 Old 04-30-2007, 05:13 PM
 
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Hi,
I'm really sorry to hear of your TTTS loss. We had it, too, with big growth problems early on that evened out from about ~20w to ~32 or so. I had hoped to make it to 35w so I could transfer to midwifery care, but at 34w when their growth was all crazy again, I agreed to an induction.

I did have an epidural, but only because I had already been on pitocin for 5 hours or so - had I known at that point I was only 2 hours away from induction, I might have tried to get through it. In any case, we were all surprised when I was ready to push - it was still 6 hours earlier than they'd anticipated, and the girls stayed head down and were born 5 minutes apart. Although we were in the OR, my doc told me he felt comfortable delivering breech if Baby B had flipped around.

Good luck to you!
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#12 of 12 Old 05-04-2007, 09:59 PM
 
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I am so sorry for your loss, Melissa.

My twins were mon/di. I was monitored pretty closely, but never had TTTS. One of my twins was always smaller, and I ended up being induced @ 37+ wks bec. by the end the difference in weight had increased more (they were 2 lbs difference @ birth). It turned out that A's umbilical cord was significantly thinner than R's cord, and it actually broke off during the delivery.

I did have an epidural (which, given my situation, I was grateful for, in the end, as I had to push A out without waiting for contrax. Their birth weights were 5/12 & 7/12.
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