30 week mono/di growth u/s today-large difference

So everything had been going great. I had no complications at all with my mono/di boys. At my last growth scan u/s at 26 weeks, they were measuring exactly the same and 2 pounds each. Today the u/s tech was having issues getting good measurements on Baby B, so she couldn't give us his weight, but Baby A was about 3 pounds (which I thought was on schedule for 30 weeks). When I spoke with the peri after, he said that Baby A was at 10% and Baby B was at 50%. My peri said that had they both been at 10%, that would have been fine and it is the large difference that is concerning. Their fluid levels are still great, so I'm not sure it is TTTS, but I guess the levels can change at any point. The peri said we will start NST and BPP u/s twice a week and check their growth again in 2 weeks. I stopped work about 2 weeks ago and was told to just take it easy, but now I have to stay off my feet all together. So, now I'm beating myself up because I stopped the protein shakes a while ago because everything was going so well. I should have known better. My husband ran to the blender as soon as we got home to make me a shake. Anyway, any advice out there? Anyone have a large size difference with mono/di twins without fluid issues?

 

Marisa, I'm sorry I have no advice. Just wanted to tell you that I hope everything turns out okay. :hug99: Please keep us updated on things. Could it also be that they were having a tough time getting good measurements of one baby and didn't get them as accurately?

 

:hug99:Marisa. Im sorry I don't have any advice. Keep us posted on their progress! GL!

 

QUOTE(TwinLove @ Aug 14 2008, 05:40 PM) [snapback]930627[/snapback]
Marisa, I'm sorry I have no advice. Just wanted to tell you that I hope everything turns out okay. :hug99: Please keep us updated on things. Could it also be that they were having a tough time getting good measurements of one baby and didn't get them as accurately?

I'm really hoping it was just due to them having a hard time measuring. I mentioned that to the peri and he said that she was having a hard time getting the head measured, but she got the stomach and that was what they used to get the 50% on baby B and 10% on Baby A. Hopefully I will know more after the BPP on Tuesday.

 

Wow, sorry to hear it, I hope the U/S was wrong....

you probably have already, but I would email or contact Dr. DeLia- he can give you a lot of great information, he needs specific information, but he seems to truly care about twin moms even those who are not his patients.. if you haven't I have his email address, it can be gotten off of his clinic's website.

That said, I am NOT a Dr. or nurse, but I THINK i have heard/think it might be possible to have growth discordance without TTTS due to unequal placental share or other placental or cord things. Again, I would strongly urge contacting Dr. DeLia if you haven't...

That said, I found a few articles and case reports on discordant growth without TTTS...

http://www.greenjournal.org/cgi/content/abstract/103/5/1115
http://lib.bioinfo.pl/pmid:16643828

 

QUOTE(TwinLove @ Aug 14 2008, 05:40 PM) [snapback]930627[/snapback]
Marisa, I'm sorry I have no advice. Just wanted to tell you that I hope everything turns out okay. :hug99: Please keep us updated on things. Could it also be that they were having a tough time getting good measurements of one baby and didn't get them as accurately?

Dont worry i had mono di twins at 31 weeks four days on june 26,2008. They were two months early they weighed 3.4ozs and 4 8ozs i was given steroid shots two weeks before baby A was real small and B was a pound different they thought he weighed less than he did but i had boy twins as well you should feel blessed that you made it to a good point in your pregnancy and just no that your perinatologist will take good care of you when i found out i was crying but i prayed and they were fine they spent a couple of weeks in the nicu and they were discharged together and they are now home. When they feel the need to they will prepare you keep your head up they will make it here just fine if you want to email me with any questions you can at [email protected].

 

I have no advice other then DONT BEAT YOUR SELF UP!!! Extra stress wont help the situation.

HUGE :hug99:'s

You are in our thoughts!!!!

 

Hi Marisa,
At my peri appt at 24 weeks, my mono/di boys both measured 1 lb 7 oz (normal). Then at my next appt at 27 weeks, A was 2 lb and B was 2 lb 8 oz. My peri reassured me that they both looked very healthy and that the most important thing was that there were no fluid disparities and that he could see both of their bladders. Also, the babies were moving a ton. Nonetheless, he wanted to see me back in 2 weeks as opposed to my regular 3 weeks, not because anything was wrong, but just because he didn't trust mono/di babies.

So I went back last week and he told me that there was no change, no fluid disparities and their bladders still looked great. And they were moving even more this time. He didn't measure their sizes because he said there wouldn't be enough of a change to make it worthwhile. I will return next week, when he will look at the bladders, fluid levels and sizes again.

In addition to the difference in the babies' growth, my ob found via transvag u/s that my cervix has started to funnel and has steadily been getting shorter (4 cm at week 28, 2.5 cm last week, I go back tomorrow to check again), even though I stopped working at 28 weeks. At any rate, all of the docs are thrilled that I stopped working at 28 weeks, and they say just take it easy and we'll watch things.

I know how you feel. Although I know none of this is my fault, my Mommy Guilt has kicked in... maybe I'm not resting enough, getting enough nutrients, etc. I hope that everything works out well for both of us (and our apparently very similar pregnancies). Just wanted to let you know that I'm in basically the same boat as you are. Good luck, and if you want to PM me to let me know how your appts go, please do. I can keep you updated on mine as well if you'd like!

Take care,
Angel

 

Thanks for the articles, your own stories, and your kind words. I had been in contact with Mary from the TTTS foundation since I found out I'm having mono/di twins, so I emailed her to see what she thought. I know they will end up being okay since I am so far along. I really just hope to get to 34 weeks. Twin10426, it is great to hear that your boys are doing well. I'll keep everyone updated next week.

 

I had TTTS starting at 18 weeks but it stabilized with bedrest and protein drinks.

The growth discordance stayed though - and my smaller twin stopped growing at the end (we delivered at 38w4d). We also had cord issues - a 2 vessel cord and velamentous cord insertion (into the membrane rather than the placenta) so that probably contributed.

Anyway, probably more important is that you stay on horizontal bedrest as much as you can - stuff yourself with good calories, protein and water, and focus all your energy on them! Then, you'll get another growth sacn in 2 weeks, right? Sometimes the trend is more important, and there is a margin of error with u/s measurements, so maybe it's a combination of the two and things will look better in two weeks!

It's great the fluid looks ok though - did they measure cord dopplers too? Abnormal doppler readings could mean something too, since that is the baby's food source! You may want to ask your dr if you're worried abbout it - but if they are monitoring you for TTTS, they would check that, though!

Good luck!
Jenny

 

QUOTE(ferfischer @ Aug 15 2008, 04:39 PM) [snapback]932318[/snapback]
I had TTTS starting at 18 weeks but it stabilized with bedrest and protein drinks.

The growth discordance stayed though - and my smaller twin stopped growing at the end (we delivered at 38w4d). We also had cord issues - a 2 vessel cord and velamentous cord insertion (into the membrane rather than the placenta) so that probably contributed.

Anyway, probably more important is that you stay on horizontal bedrest as much as you can - stuff yourself with good calories, protein and water, and focus all your energy on them! Then, you'll get another growth sacn in 2 weeks, right? Sometimes the trend is more important, and there is a margin of error with u/s measurements, so maybe it's a combination of the two and things will look better in two weeks!

It's great the fluid looks ok though - did they measure cord dopplers too? Abnormal doppler readings could mean something too, since that is the baby's food source! You may want to ask your dr if you're worried abbout it - but if they are monitoring you for TTTS, they would check that, though!

Good luck!
Jenny

Wow! Over 38 weeks with TTTS is great! That gives me a lot of hope that I can actually make it to 38 weeks. I do have another growth scan in 2 weeks and twice weekly BPP, NST, and dopplers before that. So, I know I'm in great hands with my peri. Thanks for sharing your story.

 

QUOTE(ferfischer @ Aug 15 2008, 08:39 PM) [snapback]932318[/snapback]
Anyway, probably more important is that you stay on horizontal bedrest as much as you can - stuff yourself with good calories, protein and water, and focus all your energy on them! Then, you'll get another growth sacn in 2 weeks, right? Sometimes the trend is more important, and there is a margin of error with u/s measurements, so maybe it's a combination of the two and things will look better in two weeks!

It's great the fluid looks ok though - did they measure cord dopplers too? Abnormal doppler readings could mean something too, since that is the baby's food source! You may want to ask your dr if you're worried abbout it - but if they are monitoring you for TTTS, they would check that, though!

Good luck!
Jenny


I'm sorry you're dealing with this. :hug99: We were also diagnosed with TTTS at our 1st u/s at 19 weeks and got it stabilized with 2 amnioreductions, massive calorie intake, and partial bedrest. Like Jenny, our donor baby also had a 2-vessel cord and that further contributed to her small size. We made it to 35.1 weeks before she stopped growing and we induced.

That's wonderful that your fluid levels look good because that is the really important factor for TTTS. Hopefully the whole situation is just an issue with measuring the babies. Relax, eat, eat, eat, drink tons of water and definitely ask about the cord dopplers. It's great that you have a peri who is pro-active and is keeping a close watch on you.