Types of TwinsWhat To Anticipate From The Twin Pregnancy: Basics Of Twin BirthWhat To Anticipate From A Twin Pregnancy: ABCs Of Multiple BirthWhen a Prenatal Diagnosis is Wrong Our Journey With a High Risk PregnancyWhat Is a High-risk PregnancyThe 10 Superior Skills of the Twin ParentWant to Have Twin BabiesBlogging Tips and Tricks You May Have Missed {Listable Life}High-Risk Pregnancy: Why me5 Reasons You Should Attend a Blog Conference {Listable Life}

Your Questions About Pregnancy Stages Twins

Filed under: Q&A |
Your Questions About Pregnancy Stages Twins image

Michael asks…

How early can Doctors determine whether it is twins or not?

During which stage of pregnancy one can find out whether there is more than one baby or not.
During which stage of pregnancy one can find out whether there is more than one baby or not.

What if the first scan was done in week 6, will it be clear in that scan.

Andrew answers:

They should be able to tell at your first ultrasound. I think I had my first one around 9weeks. Good luck.

- jeωeℓℓчssαs мαмα *;

Daniel asks…

is it true that i might not ever be able to carry twins ?

ok i know this is random lol ( & im not planning to get pregnant again anytime soon) but with my 3rd child i was pregnant with twins but one died in early stages of pregnancy about 7weeks the sac was empty i didnt even understand it so sorry if im confusing everyone lol but i was glad that my other baby was alright & went on to have a healthy baby boy but my mother told me that i might not ever be able to carry twins thats why i was just curious to know could this be true .

Andrew answers:

You had a vanishing twin, it happens ALL the time. And no it means nothing about your ability to carry twins.

Donald asks…

Mo-Mo twins anyone ?

Is anyone in the later stages of a Mo-Mo twin pregnancy or already gone through it ?

Were you or are you hosptialized for monitoring?
At what point?

Or if you were not, why not?

Any complications? At what point did you deliver and was it Vaginal or C-Section ?

My wife is prego w/ mo-mo twins (we think) Scan at 6 1/2 weeks show no seperation or membrane between the 2.

Any suggestions advice or stories ?

Additional Details

For those who dont know:
Mo-Mo Twins means/comes from:
Monoamniotic and Monochorionic.

Twins that share the chorionic and amniotic sac High risk pregnancy and also apparantly only occurs in less than 1% of all twin pregnancies.

Andrew answers:

Here is some helpful info from the link below. Please do not read the worst into this info. My wife and I just had our daughter on Thursday (a singleton birth) and so often we assumed the worst when faced with medical info. She is fine and are truly blessed. This info is stuff you may have already read or heard about, but I hope you take some relief from it. Blessings to you and your babies!

Cord entanglement (also called Cord Accidents) are the number one risk in this type of pregnancy. However to put this danger in perspective virtually all cases of monoamniotic twins will have tangled cords. (There are a few very, very rare cases where it is found after birth that there was no entanglement at all. But for the purposes of pregnancy management, it should be assumed that they all will become tangled to some degree.) It appears impossible for two babies to exist in the same sac without at least twisting their cords.

So simple entanglement is *not* a death sentence!

In order for entanglement to become dangerous, there must be cord compression. It is very possible to have entanglement apparent as early as 10 weeks (and probably even earlier), and still have both babies delivered safely at 34 weeks with no complications. We have had several parents here who saw entanglement at their initial diagnosis ultrasound. It is very likely that the majority of tangles begin during the first trimester when there is so much extra room to move around in. So even if you see tangles from the very start, that does not necessarily mean that you will have serious or fatal cord compression before you can safely deliver them. Nevertheless, as cord entanglement is the first sign of possible problems, that is what Obstetricians and Perinatologists will give the most amount of attention to. The weapons they have at their disposal in this fight are ultrasound, doppler imaging (a way of seeing actual blood flow through the cords), and fetal monitoring. With these tools, it becomes easier to detect problems early, before they become insurmountable.

We wish we could tell you that there was some kind of procedure that could be done to fix this condition, but theres not. There is one medication (called Sulindac) that reduces amniotic fluid volume in hopes that reduced fluid will also reduce movements of the babies. However, it is very experimental. Preliminary studies have shown good results; however, there are no long term studies on the side effects of Sulindac on either the mother or the babies. If you would like to consider this treatment, we urge you to discuss it with your perinatologist to get a better idea of the potential risks and benefits. Other than Sulindac, there are no treatments that actually try to prevent entanglement or compression. The only treatment doctors can offer is delivery. If they discover serious problems before 24-26 weeks (the point of viability outside the womb), theres nothing that can be done. After that point, if they discover life-threatening problems, they can deliver. However, the earlier delivery occurs, the higher chance that they may suffer from the complications of extreme prematurity.

While some cord accidents are sudden, it appears that the majority of fatal cord accidents are gradual. And the majority of those will show symptoms that can be detected via high resolution ultrasound and/or fetal monitoring (i.e. Non Stress Tests or NSTs). That means if you are watching often enough, you will probably see the signs of compression in enough time to do an emergency delivery before it is too late. So as you can see, the key to management of a monoamniotic pregnancy is monitoring. How much and how often is a question that you will have to address with your perinatologist. Unfortunately, there is no consensus of a best treatment plan in terms of the frequency of monitoring. Generally speaking, more is better, up to and including 24/7 continuous monitoring. There has been a recent push to use continuous monitoring, as some recent studies have shown not only higher success rates with 24/7 monitoring, but also later deliveries than those monitored less frequently. Nevertheless, there are a lot of details that must be considered when making this decision, such as financial concerns, caring for other children, or the sheer inconvenience of either traveling to the hospital repeatedly for NSTs, or the inconvenience of being hospitalized for an extended period of time. So that decision is best made between you and your perinatologist, weighing all the concerns.

One other thing that having monoamniotic twins means is that you will deliver via c-section, prematurely. How early is also a debatable matter. Some doctors advocate 32 weeks, others 34, and yet others 36. The idea is to balance the risks outside vs. The risks inside. Once you get to 32 weeks, the scariest of the preemie problems are usually past. At 34, all but minor preemie problems should be past. And at 36, they are almost considered full term. However, there is evidence that carrying past 36 weeks increases the risk of fetal death. So, given the fact that there are almost no prematurity risks at 36 weeks, there are very few reasons to carry beyond that point, and a LOT of reasons not to. Nevertheless, you have to weigh the risks of prematurity at each of these milestones with the risks of staying in utero which are considerable. The longer they stay in, the more chances there are for fatal cord accidents.

As for delivering by c-section, that is very important. If there is entanglement, there is the possibility that neither baby could be born vaginally because they are tied together so closely. Even if there is only minimal tangling, the risks of cord prolapse (where the cord of the second baby is born at the same time as the first baby, thus compressing the cord and possibly causing irreparable damage to the second baby) are too high to dismiss. Admittedly, there have been monoamniotic twins born vaginally and at term who were completely healthy. There have even been a few cases reported in the literature of safely delivered monoamniotic twins, encouraging others to attempt it themselves. Weve also had a handful of parents find us years after the birth of their children, who were shocked when they realized all the risks they had faced without knowing. After all, this condition was impossible to even diagnose before ultrasound came along, and yet there were still healthy babies born. However, the risks of both carrying to term, and of attempting a vaginal delivery are so high that few doctors are willing to risk their patients on them. And anyone whose doctor encourages an attempted vaginal delivery should think very carefully about the risks and whether they are willing to take them for the minimal benefit of a potential vaginal delivery, which could easily end up being an emergency cesarean delivery.

Another thing that you should expect from this type of pregnancy is a referral to a perinatologist. That word has been tossed around several times on this page, but what it means is a specialist in high-risk pregnancies. The newer name is Maternal-Fetal Medicine Specialists” or MFM’s. No matter what you call them, they have more experience and knowledge of how to deal with this type of high-risk pregnancy. Even if your obstetrician or family physician is comfortable taking care of you, you will still want at least a consult from a specialist. After all, this condition is so rare, it would be unrealistic to expect every OB to have studied it and to know off-hand what a proper management protocol is. Most OBs will give you this referral immediately, but others may need to be prompted by a request. Some OBs will willingly do research on their own to learn more about it; however, as long as there is a specialist available, one should be involved. Some perinatologists will take over complete care of your pregnancy, while others will simply consult with your OB through the pregnancy, advising of what to do at each stage. Either way, you will have the benefit of more experience and knowledge, and you deserve that.

So lastly, youll want to mentally prepare yourself for not only a complicated high-risk pregnancy, but also a premature c-section delivery, and very probably a NICU stay as well. We know what an enormous burden that is, emotionally. Losing the hopes for a normal pregnancy and delivery is a true loss. All of us have been in the same place you are, and we know how hard it is. Thats one of the reasons were here to help!

Mark asks…

Mo-Mo Twins. Anyone?

Is anyone in the later stages of a Mo-Mo twin pregnancy or already gone through it ?

Were you or are you hosptialized for monitoring?
At what point?

Or if you were not, why not?

Any complications? At what point did you deliver and was it Vaginal or C-Section ?

My wife is prego w/ mo-mo twins (we think) Scan at 6 1/2 weeks show no seperation or membrane between the 2.

Any suggestions advice or stories ?
Mo-Mo Twins:
Monoamniotic and Monochorionic.

Twins that share the chorionic and amniotic sac High risk pregnancy and also apparantly only occurs in less than 1% of all twin pregnancies.

Andrew answers:

I didnt have a mo-mo pregnancy, my twins were totally seperated. Having a mo-mo pregnancy or not, a twin pregnancy is ALWAYS a high risk pregnancy. You have more risk for twin-twin transfusion since your twins will be sharing a placenta. Thats when one twin gets all the nutrients and the other twin doesnt and suffers for it. I had that as well, but my twins wer born at 30 weeks (10 weeks early), and even though she was born at a very-low birth-weight, now more than a year later she is extremely healthy.

I am a small person, twin pregnancy was extrememly hard on me. I dont want to tell you all my stories (unless you really want to hear then email me) because I dont want you to think that twin pregnancy has to be bad. It doesnt. Take extrememly good care of your wife, eat an excellent diet, eat LOTS AND LOTS! The recommendations for weight gain & twins is 1lb/week for the 1st 20 weeks, 1 1/2lb/week for the last 20 weeks. Keep your activity to a minimum if she gets tired she must rest. I was put on bedrest, which is no fun but common for twins. Take a tour of your hospitals neo-natal intensive care unit 90% of all twins end up there, most just to feed & grow. Get good pre-natal care, learn about all your options.

In labour your wife will immediately be given an epidural, drugs will only be put down if she asks for them. The reason is if they need to do an emergency c-section, then the line is there and its quicker. You wont know for a long time, but if the first twin out (always the one on the left, they will call it twin a) is head down, doesnt matter what twin b is you can deliver vaginally. If twin a is feet down automatic c-section. My twin a was head down, twin b was feet down I delivered vaginally.

Have fun with your pregnancy twins are soo much fun! If you want more info, feel free to email me!

Chris asks…

What was you immediate reaction when you found out you were having twins?

Both my wife and I were super excited, but then the next day worried and scared. From what I have read it shouldnt be to difficult, just more expensive in the early stages. This is our first pregnancy so we wont know any different.

Just wanted to know others reactions to finding out they were having multiples.

Andrew answers:

I think we went through the same super excited, absolutely terrified . . . We alternated between the two! My husband saw them on the ultrasound before I did his facial expression was priceless! It went from Wow, there is my baby to Wait, are there 2???

My advice from a parent of twins, to an expecting parent of twins is the following:

1) Find an good doctor / midwife with experience in delivering twins. Then trust your gut and call the doctor with any questions or concerns. Eat right, stay active it will make for a better pregnancy and even though you are asking the question as the husband eat right and be healthy with her because it is awfully hard to eat your grilled chicken salad when someone is sitting across the table with a meatball sub!

2) Build your support system to help after the babies arrive and then LET them help whether it is to hold a baby, cook dinner, throw the laundry in etc . . .

3) Get your twins on the same schedule. The easiest way to do this is to feed them at the same time or back to back. Even if this means that you need to wake a sleeping baby. If you let them sleep and wake whenever you want then your hands will always be full. If one wakes to eat, then you feed him or her and then wake the other to eat. In time they will fall on the same schedule.

4) Dont let people scare you with things like wow, twins, I could never do it or wow twins, one is hard enough that will be so much work, I couldnt imagine blah blah blah. You are first time parents you have no clue how much work one child is . . . So having 2 will be your reality and you will do fine!

Congrats and best wishes! Twins are such a blessing!

Powered by Yahoo! Answers


Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>