Worried about size discrepancy with Mono/Di twins....

Could a 10% size discrepancy at 14 weeks be the beginning of TTTS?

So, I may be overreacting, but I am a bit worried- I am just 14 weeks and had a perinatal appt. today. The doctor says the babies look good, the fluids are good and no-one looks stuck, but he did mention a 10% discrepancy in size. Baby A is 10% smaller. This freaked me out a bit, but he said it may not be a discrepancy but just due to ultrasound possible errors.

My next appointment is with my regular OB on the 16th. Is it OK to wait until then? Should I take his word for it that everyone is OK for now?

Has anyone else with mono/di twins had any size discrepancy and had it not be TTTS?

 

My mono/di twins had ttts, but there was no size difference until baby b was actually stuck. I would trust that everything is ok for the time being if you develop ttts you will notice a difference in your belly, a huge difference like all of a sudden it gets really big or everything shifts. I think that most twins have some size difference, so you probably don't need to worry much about that yet. If anything feels weird or you start getting contractions or anything though call your doctor.

 

QUOTE(tx3smith @ Jun 4 2008, 01:50 PM) [snapback]809937[/snapback]
My mono/di twins had ttts, but there was no size difference until baby b was actually stuck. I would trust that everything is ok for the time being if you develop ttts you will notice a difference in your belly, a huge difference like all of a sudden it gets really big or everything shifts. I think that most twins have some size difference, so you probably don't need to worry much about that yet. If anything feels weird or you start getting contractions or anything though call your doctor.



Thank you so much for your response! And it is reassuring to know that you experienced some things happen that you could notice, too....

 

My boys had TTTS as well and there actually was never really a huge differance. At birth (34 weeks) they were 3.5 and 4.1. However, at my 14 week appointment baby B was stuck (although the stupid tech didn't know what that meant, neither did I until our 18 week). At 18 weeks is when we got our official TTTS diagnosis.

If I remember right, there's not much you can do for TTTS before 18 weeks (or is it 16?) so seeing them before the 16th wouldn't make a differance anyhow. Someone please correct me if I'm wrong about that.

 

For us, the size difference grew gradually over time. When we were diagnosed at 19 weeks at our 1st u/s, Baby B wasn't too much smaller than Baby A but their fluid difference was huge.

At that size, it only take an ounce or a fraction of one to make a 10% size difference. One slip of the measurements during the u/s and you have two very differently sized babies. The biggest diagnosis factor for TTTS is the difference in fluid amounts so that is what you should be watching. The difference in size may be due to measurement problems, how the baby was situated, a less ideal placing of the umbilical cord on the placenta, etc.

Is your next appt. and u/s or just a regular appt? Starting by 16-18 weeks you should be getting at least biweekly u/s to watch for TTTS.

 

Just a head's up, but it is not true that you will feel a big shift or experience sudden swelling in your girth with TTTS. . . you may, you may not. It depends on the severity of the polyhydramnios. I have been in Stage I TTTS since 19 weeks, and I never experienced that despite my polyhydramnios (which is not as severe as some cases. . . mine has measured 9 to 13 cm, which is abnormal).

My babies had a 20% size discordance at 19 weeks. That 20% number or higher is an indicator of TTTS. Also, at 21 weeks, the smaller baby had less than 2 cm fluid while the larger baby still had within normal range of fluid.

As long as you are being monitored every couple of weeks, it's a very good thing. If you do feel that sudden girth expansion (also notable in a sudden weight gain), do see your doc.

Have you checked out the TTTS Foundation website? It has some great info on what to look for as well as recommendations for care in any identical pregnancy.

 

QUOTE(Ali M @ Jun 4 2008, 02:37 PM) [snapback]810060[/snapback]
For us, the size difference grew gradually over time. When we were diagnosed at 19 weeks at our 1st u/s, Baby B wasn't too much smaller than Baby A but their fluid difference was huge.

At that size, it only take an ounce or a fraction of one to make a 10% size difference. One slip of the measurements during the u/s and you have two very differently sized babies. The biggest diagnosis factor for TTTS is the difference in fluid amounts so that is what you should be watching. The difference in size may be due to measurement problems, how the baby was situated, a less ideal placing of the umbilical cord on the placenta, etc.

Is your next appt. and u/s or just a regular appt? Starting by 16-18 weeks you should be getting at least biweekly u/s to watch for TTTS.



Next appointment is 'regular' with my OB (not perinatologist), but they do an in-office ultrasound at each appointment

 

I agree with the others, it will be a couple more weeks before you can make a TTTS diagnosis anyway. After 16-18 weeks, I would want u/s at least every other week.

I also had a 20% discrepancy at 16 weeks, but fluid was ok. At 18 weeks, it was still 20% discrepancy, but one twin was stuck. It's not always true that you will notice.

There ARE things you can do to try to help the situation in there. Take it easy, rest as much as you can. The idea is that if you maximize blood flow to the uterus it will help the babies grow - this means being horizontal and not exerting yourself. Also, the dreaded protein drinks. No one hates them as much as I do, but I dutifully drank 3 of them a day for 21 weeks. Drink lots of water. Eats lots of calories. It can help!

In our case our babies were 1lb diff at birth, and my donor needed oxygen and wouldn't suck, despite being full term. She had velamentous cord insertion and her cord was only 2 vessels, on top of the TTTS! But, the bedrest and protein drinks helped. It certainly won't hurt!

Keep us posted!
Jenny

 

QUOTE(Emily@Home @ Jun 4 2008, 12:49 PM) [snapback]810090[/snapback]
Just a head's up, but it is not true that you will feel a big shift or experience sudden swelling in your girth with TTTS. . . you may, you may not. It depends on the severity of the polyhydramnios. I have been in Stage I TTTS since 19 weeks, and I never experienced that despite my polyhydramnios (which is not as severe as some cases. . . mine has measured 9 to 13 cm, which is abnormal).

My babies had a 20% size discordance at 19 weeks. That 20% number or higher is an indicator of TTTS. Also, at 21 weeks, the smaller baby had less than 2 cm fluid while the larger baby still had within normal range of fluid.

As long as you are being monitored every couple of weeks, it's a very good thing. If you do feel that sudden girth expansion (also notable in a sudden weight gain), do see your doc.

Have you checked out the TTTS Foundation website? It has some great info on what to look for as well as recommendations for care in any identical pregnancy.


IT's true that you might not feel or notice anything different but stage 1 is very minimal. I was in stage 3 and it happened very quickly.
The TTTS foundation is not based on science at all. If you want resources check out ourbaby.org and fetalhope.org

 

Oh, I also wanted to add that there can be a size difference with mo/di twins without TTTS, but it may have more to do with cords, cord insertion, placental share. We happened to have problems with the cord as well as the TTTS. It's very common to have both.

 

QUOTE
The TTTS foundation is not based on science at all.


The Foundation does support scientific research and also provides scentific research information on its website. Their message boards are more for support though!

 

I had a 20% size difference at that point in pregancy. My fluid levels have fluctuated, but never have been in range of TTTS. Now at 24 weeks, their growth discrepancy is only 9%. Like a previous poster mentioned, their is so little difference in size at that point that it it easy for the ultrasound measurements to be off just a bit. We are being monitored every 2 weeks and at one point every week just to be sure the fluid levels were ok.

So, hopefully, your size differential will just be that...only a size differental!

 

Hi, I had surgery 2 weeks ago for TTTS and our twins hardly had any size difference then and they were at stage 2. I think there are far more important things that would show up this early that you need to worry about with TTTS than such a small difference in size at this stage ie, a major difference in fluid levels between twins and lack of a bladder in the twin with low fluid. They are so little at that point too (14 W) that a few grams could give you the 10 % and I think most doctors say the margin for error with their ultrasound equipment would be +/- at least that much.

I think as long as you get ultrasounds every 2 weeks you are being well looked after. Good luck and I hope you never have to worry about TTTS (or any other complications for that matter!).

Kristin

Brody born Sept 9, 2005

26 W with identical girls that so far have survived Stage 2 TTTS after laser surgery!

 

At 13 weeks ttts was suspected for us and that led to me being immediately seen by specialists who at that time told me it was normal to have a discrepency in sizes that early on but they would keep an eye on me since I couldn't have surgery until 16 weeks. I went back at 15 weeks and they confirmed ttts due to no bladder, size/fluid difference and abnormal dopplers. Immediately sent to surgeon the first day of 16th week though I never got the surgery. I stayed stable the entire pregnancy and even though I went back and forth with polyhydraminos I never ever got bigger or anything that would have concerned me. Never needed amnio drainage either so you can't always tell just by a sudden weight gain. Weeks that my fluids were acceptable, my donor would have marginal/bad dopplers that would concern the doctors. Something we'd never have known without all the monitoring. So it may be nothing but I'd make sure I was being monitored by 16 weeks just in case you take a turn for the worse.