Specialist or not?

[TwinJade]

My husband and I just found we are having twins.

Should I be referred to a "high risk" OB?

Am I a "high risk" because I am carrying twins?

[Laurie13]

I think all twins are higher risk just because of the strain they put on your body. Some people do very well and don't need to be referred to a perinatologist but most moms see them at least a couple times for a level II ultrasound. It also depends on your age and if you have had any previous problems with pregnancies as well. Some moms see both their regular OB and a perinatologist and some see just one or the other.

We saw our regular OB every 2 weeks until 28 weeks and then weekly and saw the perinatologist every three weeks for the level II (which is a higher definition ultrasound) and then for NST (non stress tests) twice a week at the end.

Good luck, discuss this with your OB, every doctor is different.
And CONGRATS!

[lflee]

We've gone to a peri twice so far, and will be seeing bothe the peri and my regular OB. We were hoping to use the peri exclusively, since we're not happy with our regular ob, but the peri said today that we're not high risk enough....I'm just turning 35 and my identical twins are doing fabulously (and apparently my cervix is long, which is another good thing). So, we will continue to go to both. The peri will serve as the managers and will answer my questions and concerns, and the reg ob will be keeping an eye on me too so that they will know what to expect when I deliver.

[2girls2girls]

Hi there and Congratulations!!

My only advice to <i> anyone </i> who is having twins is to get a specialist. We pondered and pondered and never did. My doctors assured me I didn't need a specialist, but as it turned out I developed HELLP Syndrome and to be quite honest, my doctors almost cost me my life. I'm not trying to scare you, but if I had it to do over again, I would absolutely have had a specialist.

[allsmilz]

i was going to just use my regular ob/gyn with the consult of a perinatologist, but other complications have caused my ob to release me from care and Im only seeing the specialists now.

[lflee]

What's HELLP syndrome?

[oneplusII]

I would definately recommend a specialist for any Mom that is having twins. At 21 weeks of my pregnancy during a level II ultrasound my doctor discovered I was 90 % effaced. He immediately admitted me to the hospital and did a cerclage. I was going to him every other week at that point. If I hadn't seen him and if he hadn't checked my cervix I could have lost my babies.

Like Heather said, I am not trying to scare you, just inform you.

Congratulations by the way and hope to hear more from you. :)

[2girls2girls]

Originally posted by lflee
What's HELLP syndrome?

HELLP Syndrome is a group of symptoms that occur in pregnant women who have (H) hemolytic anaemia, (EL) elevated liver enzymes, and (LP) low platelet count. HELLP is the medical term for one of the most serious complications of pre-eclampsia, in which there is a combined liver and blood clotting disorder.

HELLP syndrome occurs in approximately 10% of pregnant women with pre-eclampsia or eclampsia. It may occur long before a pregnancy reaches term (for example, 30 weeks gestation). Or as late as after delivery. HELLP may occur without an associated elevation of blood pressure.

Early and continuing prenatal care to facilitate early identification and treatment of conditions such as pre-eclampsia and eclampsia may help to prevent the disorder.

Symptoms of HELLP Syndrome are:

progressive nausea and vomiting
upper abdominal pain
headache
Signs and tests are:

Examination shows upper abdominal tenderness, especially in the right upper quadrant. The liver may be enlarged.
Liver function tests (liver enzyme tests) may be abnormal.
The only treatment is delivery of the infant. This is essential because liver function rapidly deteriorates in this condition. Haemorrhage may occur within the mother's liver. Permanent liver damage may occur if delivery is delayed.

Call your health care provider or obstetrician if symptoms occur during pregnancy. HELLP syndrome can rapidly progress to an emergency condition.

I took this from a HELLP website just so that I was able to answer your question properly. My doctors really had no experience with it and for me, it became life threatening. Had I obtained a specialist, I don't believe it would have gotten to that point.

Like I was saying, if I had it to do over, I would have definitely gone to a specialist.

[dosmas]

Congratulations!!!

I concur with what has been said, and wanted to add that you probably don't need to see a high risk OB, but you definately should see a perinatologist in addition to your OB. Your OB should refer you to one for your multiple ultrasounds. As far as your OB goes talk to him/her and get a feel for how they handle twin pregnancies i.e. how often you will see them, when you will be refered to the peri, and what other special care you might receive. The extra care really does give you piece of mind. I happen to be going to a high risk OB, and I don't find that the care is much different from a regular OB; however, he immediately spoke to me about the extra appointments I would have and about seeing a peri. His office also coordinates the care well which is nice.

Good luck :-)

[2boyz4us]

I've read this thread several times and haven't responded because I had mixed feelings about my high risk OB. He seemed overly conservative, made me quit work at 24 weeks, didn't let me exercise (not even a prenatal yoga class). And as it turned out I seem to have avoided most of the things twin pg's are high risk for: preeclampsia, gestational diabetes, twin-to-twin transfusion (that's with identicals only) -- the list goes on. . . so I might have been just fine with a regular OB.

But I have to say, after reading Melissa & Mike's experience this morning, I am extremely grateful to have a doctor who errs on the side of being overly cautious.

BTW, there are probably lots of high risk OB's out there who aren't as conservative as my guy. The high-risk doc as a consultant also sounds like a good idea.

Good luck & congrats on your pregnancy

[brooklynmum]

2boyz4us: I'm also in Brooklyn and was wondering what the name of your high risk doc is. I'm currently seeing my regular OB and am considering seeing the specialist as well, but don't know where to go...

Thanks!

[tssecord]

I just wanted to say that I only saw my regular OB, but I had a very easy pregnancy and am young so there was no concern. Like others have said it all depends on your age, your history, and anything unusual that has happened so far. I think every mom to be needs to make that decision based on her pregnancy and it wouldn't hurt to consult your current doctor to see what they think!

Many moms, even moms with twins, do great with just an OB! :)

[2boyz4us]

Brooklynmum-- I'm seeing Steven Ordorica at NYU. His number is 212-263-5982.