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  1. #1

    Default Others out there with mono-di identicals?

    Time marches on . . . I can't believe this will be week 35. The anxiety, exhaustion, anticipation, etc are all becoming extreme and unpredictable!

    Is anyone else out there carrying mono-di twins? Identical twins that share a placenta but have different sacs? I guess with these kinds of twins there is a point where keeping the babies in has diminishing returns because the placenta can't sustain both of them and acute TTTS is a concern. What are your doctors doing about delivery dates? My OB has said that they should be done at 36 weeks. The peri says maybe 37. I'm confused. And anxious.

    Many thanks!
    --Jane

    Blogging at: http://morgan-zawilski.blogspot.com/

    Daughter Born 5.19.07
    Found out we were having identical twins - 6.6.08 at 18+ weeks - SURPRISE!

    Identical boys Cole and Owen born 10.10.08 at 36w2d. No NICU.
    6lbs 1 ounce and 6 lbs 8 ounces




  2. #2

    Default

    My peri doesn't think that TTTS is a concern if you haven't seen it up to 26 weeks. I have biweekly scans until 26 weeks and then they stop monitoring for TTTS (so far no sign - they've been exactly the same size all the way through!). She also never mentioned that mono-dis have issues with the placenta sustaining them full-term. They seem to think that once we clear the possibility of TTTS and unequal placenta sharing, that there shouldn't be anything higher risk about mono-di vs. di-di twins.

  3. #3

    Default

    I have mono-di identicals and my peri has said the same thing as yours -- they "won't let me" go past 38 weeks because the placenta starts diminishing in efficiency to sustain both babies. They want me to deliver at around 36 weeks, ideally. My OB didn't give me the "ultimatum" of 38 weeks, but expects me to deliver by then anyhow.

  4. #4
    Join Date
    Jun 2008
    Location
    Wisconsin
    Posts
    482

    Default

    My doctor told me probably not letting me go past 37 weeks. As far as TTTS, it can develop at any time with only 1 placenta. I will be monitored for it up until like 34 or 35 weeks. Mine are also at a 20-25% weight difference so I don't know if that's why they will keep checking or not. My husband's aunt had identical twins and they had to take them by c-section at 35 weeks because TTTS had started to develop and they said it wasn't worth the risk of keeping them in.




    Austin 3lbs 1oz 15 1/2in
    Ethan 4lbs 6oz 17 1/4in
    Born at 32 weeks and 5 days
    Ethan 5 weeks in the NICU
    Austin 6 weeks in the NICU

  5. #5

    Default

    I'm having mono-di twins and my Peri told me not to worry about TTTS. She wouldn't even talk to me about it when I asked her a question. She said why worry when things look so great.
    My boys are w/in 7% of each other in growth.

    My doctor told me they wouldn't allow me to go past 38 weeks he is hoping I make it to 36 weeks and right now I'm doing so well and so are the boys I think 38 is hopeful!



  6. #6
    Join Date
    Jul 2008
    Location
    California
    Posts
    661

    Default

    I have mono/di twins. I was told at my first peri appointment that they wouldn't let me go past 38 weeks because the placenta isn't able to properly nourish the babies after 38 weeks. I don't know if that's the case for all twins, or just mono/di twins (didn't think to ask). We've never discussed a specific delivery date. So far they haven't seen any signs of TTTS. But I hate having to wait 4 weeks for each checkup.
    Tiffany




  7. #7
    Join Date
    Jun 2008
    Location
    Indiana
    Posts
    637

    Default

    I have Mo-di twins. The Peri checks for TTTS. WE have never had a problem. THey are very close in weights (with in 7oz of one another)..

    However, my dr.s won't schedule a c-section until 39w... but, all think I will never make it that far. I'm hoping to deliver this week..lol But, we have to wait for me to go into labor, or something else to cause it.
    Luke and Mason



  8. #8

    Default

    Good to know that there are others out there. Seems as though the doctors are all over the map. I saw my OB today. We have had no sign of TTTS and above average size babies. She is scheduling induction for 36w1day. I am 2cm dialated, 80% effaced and she said there is a 50% chance that I will go before the induction. Is anybody contemplating vaginal delivery with these types of twins? Anybody heard any warnings against it?
    --Jane

    Blogging at: http://morgan-zawilski.blogspot.com/

    Daughter Born 5.19.07
    Found out we were having identical twins - 6.6.08 at 18+ weeks - SURPRISE!

    Identical boys Cole and Owen born 10.10.08 at 36w2d. No NICU.
    6lbs 1 ounce and 6 lbs 8 ounces




  9. #9

    Default

    I also have mono/di twins. My Peri says the goal is to get me to 38 weeks and not past. My OB says 36 weeks. Neither will schedule anything yet (I'm at 30 weeks right now). As for TTTS, I get regular growth scans at the Peri and everything has been fine so far (boys are not identical in weight, but are close enough). But like a pp said, it can crop up at any time and is random. I am not contemplating a vaginal delivery, but that's primarily because I had a previous c-sec and know that my body doesn't do well with labor and delivery with singletons, let alone twins. I haven't heard of there being any special issues with mono/di twins when it comes to vaginal delivery, but I haven't asked either.
    -Kristen

    DH: Carl
    DS: Davis (14)
    DSD: Brisa (8)
    DD: Holland (2)

    Expecting identical twin Boys - 12/5/08


  10. #10

    Default

    I have mono-di and my peri told us that afer 26 weeks, TTTS is very rare. They do still keep an eye on fluid levels etc. I was told full term for me is 38 weeks but I doubt I will make it that far. My boys have a weight difference as well. From my review of the leiterature, TTTS can occur any time but later is much rare.
    I do however relate to the stress of having moni-di twins as we have to worry about so mcuh more.

  11. #11
    Join Date
    Jan 2008
    Location
    Canada
    Posts
    136

    Default

    Jumping boards......

    I also had mo-di twins, but with a TTTS diagnosis at 21 weeks. I delivered at 32 weeks, but never would have gone past 36 weeks, even if everything had normalized. All the research I have done on the subject has shown no real benefit to going beyond that point with this type of twins. And YES, TTTS CAN happen at any point, even if no signs have been seen. An acute transfusion can occur at the time of delivery, regardless of previous indications.

    Obviously different doctors have differing opinions on what is a safe delivery point, but you do have a say in what is done. Also there is an increased chance of acute TTTS in vaginal deliveries, because of the delay between the birth of the first baby and the second. It's a more controlled event during a c-section, and generally the babies are born very quickly, therefore there is less risk of a massive transfusion.

    Good luck to all of you, and wishing everyone a safe an relatively uneventful birth.
    Melissa, proud mom to Samantha (10/24/98), Dominic (3/1/03), and TTTS survivors Isaac & Matthew (10/25/04)

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