Saturday, May 4, 2013

An explanation

I thought I'd send out a little information I've collected over the past few days. I don't think any of you think I'm "complaining" about having identical twins, but I wonder whether you understand just why I am so freaked out.

The chance of this happening is less than 1% (more like 1 in 60,000). What I have is likely "momo twins". If they see a membrane between the two fetuses, then it'll be "modi twins". The name refers to whether the fetuses share both a placenta and an amniotic sac (momo) or whether they share both but there is a membrane between them (modi). (I am not positive on modi because I haven't researched it fully yet)

There are a number of dangers that go with identical twins, including "twin on twin transfusion syndrome." Essentially, this is when one twin becomes the dominant twin and takes all the nutrients, leaving the other twin malnourished (and suffering severe birth defects). For the dominant twin, however, getting all those extra nutrients can also be dangerous, and both twins can die or be born with birth defencts. I know two women personally who went through TTTS; one gave birth to two babies and one is healthy while the other died at 18 months old. The other woman was diagnosed very early and had a lazer surgery to somehow do something that allowed both of her babies to thrive and survive; they are now almost 2 years old.

Additional dangers include the umbilical cords (they each have a separate one of these) getting all tangled and even knotted up, preventing any nutrients getting to either. That is less of a concern when they are smaller but as they grow and have less room in there, it becomes a higher concern.

I will need weekly monitoring at the very least, and perhaps more. I already have an appointment with a perinatologist to get the extra special care I will need.

Here is a pretty useful link on momo twins:

If these are momo twins, then there is a good chance, based on what I've read, that I will be hospitalized around week 24 and that the twins will be delivered sometime between 26 and 34 weeks. The earlier they come, the longer they will be in the NICU. They must be delivered by c-section because, in sharing a placenta, if one comes down the birth canal, it will cause a placental rupture of the other left behind.

This is all VERY early. Based on my history, even in this pregnancy with baby A dying, there is a very good chance that one or both of them won't make it much further. I have never gotten further than my 9w2d ultrasound, which is about 2 weeks from now. I am 7w2d today.

Also, based on some reading I came across, I do not know whether the problem is solved if one of the two dies. I read somewhere that damage could have been done at the splitting, meaning a surviving fetus may still have defects, even if there are no longer TTTS or entangled cord concerns.

It is really important to me that you realize why I am so terrified and scared and seemingly ungrateful for what is (hopefully still) growing inside of me. After all we've been through, we were hoping for a somewhat normal and easy path to parenthood. Apparently that is not in the cards for us.


  1. I don't think there is one person here who knows what is going on with you question why you are in the state you are. I am here foryou always and hoping with my whole heart that this pregnancy continues and your babies are healthy. If they are anything like you then I can n say they are fighters!

  2. Oh sweetie, even if we haven't all been there ourselves we all know how scary this is. Nothing is easy about this journey, including the knowledge that joy is always tempered by those fears. We understand, and we are here for you. You're not ungrateful, you're being a loving mama who is worried about her babies! Continuing to send so many healthy vibes your way.

  3. Momo twins are stressful for all the reasons you stated. Add in your history and it completely understandable why you're terrified. As hard as all this is, try to focus on what you can do during this time. In addition to eating well and taking hood care if yourself, now is the time to look for support. In addition, look into finding a care te that specializes in twins. I can't emphasize how important this is as most OB/GYNs only have base knowledge, so being with a group that specializes will help relieve some of the anxiety.

    Thinking of you during this time.

  4. I'm starting to think that there is never a normal pregnancy among those of us ttc with ART.