Monday, November 21, 2011

The best news we could have received!

We had our 17 week appointment at the IWK tonight.  We didn't get a lot of information during the visit, but I will share what we now know.  The technician was pretty quiet as he snapped his pictures.  My uterus looked like a boxing ring with the twins facing each other while kicking and punching with their tiny limbs.


Dr. MacLeod came in and took a look for herself.  One twin is now 6 ounces and the other is 7 ounces, so they are still sharing very well.  Everything looks healthy, and the technician got some great anatomy shots.  One of the twins (B) was around my belly button, and the other (A) was up near my ribs.  They are both hanging out on the right.  They also did a probe and told me that I have a "super-cervix" which will cut down on some worries about premature labour.

Now for the best part.  Though she could not give a definite, it seems as though there may be a membrane between the twins.  It was very faint, so she couldn't say for sure, but it's looking good.  We will be going back in 2-3 weeks.   A membrane would mean mo/di twins (so I may have to change the name of my blog), and we would no longer have to worry about cord entanglement or compression.  It is still a  high risk pregnancy (as all multiples are), but now we would just be looking at TTTS (twin to twin transfusion syndrome) as a possible complication, and that takes a great amount of pressure off.  Hopefully at the next ultrasound, we will know for sure about the membrane.

We were going to be told the sex tonight, but both of the babies had their legs tightly squeezed together (such ladies/gentlemen they are).  Maybe next time.
On the top you see our 12 week ultrasound.  Baby B is on the left, and Baby A is on the right.  They are reversed on the bottom for our 17 week.  As you can see, Baby A is still kicking back and relaxing.  You can see him/her from the back (head on the right) on his/her side.

I also found out that I will be off work at Christmas.  What will I do with my time?

Friday, November 11, 2011

A More Recent Study

I have been reading some posts about the 50/50 mortality rate coming from outdated studies at a time when hospitals did not have the technology to monitor women during their pregnancies.  This is one of the most recent studies I could find, and it shows only an 8% mortality rate, and out of the survivors, 88% were completely normal.  

Journal of Perinatology (2006) 26, 170–175. doi:10.1038/sj.jp.7211457; published online 9 February 2006
Monochorionic monoamniotic twins: neonatal outcome
L Cordero1, A Franco2 and S D Joy2
Department of Pediatrics and Obstetrics, Division of Neonatal-Perinatal Medicine, College of Medicine and Public Health, The Ohio State University Medical Center, The Ohio State University, Columbus, OH, USA leandro.cordero@osumc.edu
Background: Monochorionic monoamniotic twins (MoMo) occur in one of 10 000 pregnancies. Cord entanglement, malformations, twin-to-twin transfusion syndrome (TTS) and prematurity are responsible for their high perinatal morbidity and mortality.
Objective: To report our experience with 36 sets of MoMo twins (1990 to 2005) and to provide updated information for counseling.
Methods: Chorionicity was determined by placental examination, gestational age and TTS clinically and by sonography. Intrauterine growth restriction (IUGR) was diagnosed with a twin-specific nomogram.
Results: Cord entanglement was observed in 15 pregnancies, but only one twin with entanglement and a true knot, experienced related morbidity. Four of 71 live births were IUGR. Malformations were diagnosed prenatally (one hypoplastic left heart and one body stalk) and postnatally (one vertebral anomalies-anal atresia-tracheoesophageal fistula-renal defect (VATER) and two lung hypoplasias). Twin-to-twin transfusion syndrome affected three sets of twins. Five twin sets delivered before 31, 19 sets at 31 to 32 and 12 sets at 33 to 34 weeks. Six of 71 (8%) twins died (four malformations, one TTS and one 26 weeks premature). Head ultrasounds in 59 of 65 survivors showed two (3%) periventricular leukomalacia, five (9%) Grade I–II intraventricular hemorrhage and 52 (88%) normal. Conclusions: Monochorionic monoamniotic twins remain a group at risk for cord entanglement, congenital malformations, TTS and prematurity. Although their neonatal mortality and morbidity is high, outcomes for survival are better than anticipated.

Dreams and Bellies

I am really starting to show this week, and some of my students have commented on that (gotta love their honesty).  The scale is showing about 2 or maybe 3 lbs gained now, but I am not entirely sure how accurate that scale is.  I don't actually have a  bathroom scale of my own, and I would like to keep it that way if possible.  I used to weigh myself obsessively when one was available, and would like to ensure that that does not happen again.

I am up early this morning, mostly due to the fact that I had a full bladder, but also because of the vivid dreams that have plagued my sleep recently.  They are not nightmares, but I am not used to being able to remember my dreams when I wake up.  Lots of them involve school (which is nothing new), many involve long complicated "quests", and some are sexual in nature.  Maybe I should start to write some of it down.

Saturday, November 5, 2011