identical twins - one placenta

Went for my 20 week sono yesterday and they spent a huge amount of time searching and documenting the placenta. (Apparently, my doc off and sonos never document the placenta)

They found yesterday that I only have 1 placenta for my 2 girls , which we also confirmed are identical girls.

Its supposed to be a wonderful moment for my DH and I but hearing all the risks and being referred to a high risk doctor and the risk of twin to twin transfusion (TTTS) is way to scary for me.

Has anyone had any experience with this or have any advice? Im dying here and so upset, even though, nothing has been told me yet.

I go to the high risk doc on Friday morning for a sono and consultation.

Re: identical twins - one placenta

Sorry, no experience with this but just wanted to share hugs and prayers!

Good luck at the high risk! I felt very secure seeing my high risk doctors weekly during my pregnancy!

Re: identical twins - one placenta

I knew I had 1 placenta from very early on (8 weeks).

At 11 weeks twin a was measuring larger and they mentioned I was at risk for TTTS. I went back a week later for more measurements and twin b had caught up. And going forward it was never brought up again.

I know how scary all of these medical terms can be. Hang in there.

Re: identical twins - one placenta

Yes! I had mono/di twins (one placenta, two sacs) and at 16 weeks was put on bedrest because they were showing signs of TTTS because there was a discordance of fluid though they were both weighing around the same. I went on the foundation website and did what they suggested -- drinking 3 Ensure drinks a day and laying on my left side as much as I could. I also drank a LOT of water. At one point my Baby A's fluid was 1.8 cm and B was 7.8 cm (something around that) and Stage 1 is when one baby is below 2 and one above 8. Thankfully around 24 weeks I think it was, they started balancing out, and it got a lot better, and I made it to just shy of 36 weeks without any problems. I was checked weekly by the high risk practice though.

I would DEFINITELY be checked at least every 2 weeks though. Actually, maybe even weekly. You are probably fine, but they should always be checking to make sure the fluids are okay. I'm sure your high risk dr will know what's best and be checking you. Good luck!

Message edited 5/31/2012 9:41:46 AM.

Re: identical twins - one placenta

My boys shared a placenta but had individual inner sacs. I was monitored every two weeks for most of my pregnancy in case signs of TTS were there. Thankfully, all was good. Towards the end, there were signs of uneven fluid amounts, but they evened out by the next sono. I was on bed rest for the last 2 months, but I think that is my doctor's protocol for all twins. Hang in there!

Re: identical twins - one placenta

thank you ladies.. i go tomm morning and will keep you posted

Re: identical twins - one placenta

so obviously, its been a tough 2 weeks.

ive been going to my high risk doctor on tues and fridays to be monitored. im still shy of stage 1 ttts - dont have it, but they are always watching and also telling us all the options we may be needing to make in the next few weeks.

im praying (and crying) a lot that everything is ok, but it just looks like baby a (donor) keeps passing along nutrients and all to baby b (recipient) - baby a is 1.1 lbs and baby b is 1.6 - which is fine, their fluid levels are what they are watching.

the doctor wasnt impressed with me mentioning boost/ensure for the protein - ive been having a carnation instant breakfast shake midmorning and trying to have more protein in my diet.

ive stopped work and hopefully in this week, things can improve, but there really isnt anything i can do.



*if you have had any experience with this - please let me know - im driving myself nuts over here. thanks

Re: identical twins - one placenta

my sister and I are identical, 1 placenta. My mom went 39.2 weeks and we were 8.3lbs and 7.3lbs! i know that doesnt mean much but I thought it might offer some positive hope!

Re: identical twins - one placenta

So sorry to read what you are going through. I am pregnant with triplets which include a set of monochorionic twins. We knew early on that 2 of them shared a placenta and I was encouraged to reduce them because they too showed an increased risk of TTTS. I was a complete wreck and the doom-and-gloom predictions I received were devastating. My personal theory though is that doctors are obligated to relay worst case scenerio info to you, lest they be sued later. Also doctors calculate risk differently than we do. I faced a 30% chance of severe TTTS which was enough for the specialists to recommend reduction of 2 fetuses. As a layperson, all I heard was that they had a 70% chance of being ok! But to them, it was an unacceptably high risk. FWIW, once my husband and I decided not to reduce, they supported us unconditionally and provided excellent care t/o the remainder of the pregnancy. It's hard not to take it personally but I really think they are just doing their job.

Like the poster above, I reached out to the TTTs foundation - they have a ton of info but also a lot of religious undertones if you are ok with that. The best thing they did was put me in touch with Dr. Julian DeLia, one of the pioneers of the laser ablation therapy used to treat TTTS. He gave me hope when there was none. I followed the recommendations about Boost, Ensure etc. It is medically unproven and thus most doctors won't endorse it. But I put it in the "can't hurt, might help" category. I wouldn't necessarily give up on it just because your doc is skeptical.

Anyway I am 33 weeks along with all three and we are doing great - TTTS never reared its ugly head. Try to take it week by week- once you reach 26 weeks you can exhale a little because viable delivery will soon be an option. And Dr. DeLia had very positive things to say about the laser ablation therapy, so there is that option too. Best of luck to you, I know how devastating it is to hear that there may be something wrong with your babies.

Re: identical twins - one placenta

thank you so much! it really means a lot you both responded..

tripletmom2b - wow - thanks! my doc always stays positive but i hear all the negative. im just really scared something will go wrong, even though its pretty much out of my hands.. I will go get some boost - i think with all the girls on ttts foundation saying they drank it, might as well.. im with you - cant hurt!

how are you doing - wow - triplets!!! good luck to you and congrats on making it to 33 weeks - thats what i pray for 34 weeks!

Re: identical twins - one placenta

I also had 1 placenta, 2 sacs. I was told identical but when I vaginally delivered them the Dr said it looked like two placentas could have fuzed. that means they could be fraternal or identical. We still dont know and they are a year old!

I didnt have twin to twin transfusion but my friend had to deliver around 28 weeks due to this. One of the babies is thriving and the other is going through a roller coaster of problems. I pray that you dont have to go through that! Either way there are great hospitals and Doctors out there!!! Think positive!

Re: identical twins - one placenta

I had mono/di identical twin 6 years ago. I was watched very carefully and had a high risk doctor and regular doctor who delivered them. I went in for sono's on a weekly schedule and also got dopplers every week. After 30 weeks I went in for week stress tests too. Around 33 weeks TTTS started rearing it's ugly head and they decided to take them at 36 weeks because of issues they were monitoring. Boys were fine and needed no NICU time.

It's a very scary time, but just hang in there and take very good care of yourself. They really monitor you closely after 16 weeks so if anything starts changing they take action.

My high risk doctor told me when we started meeting, that the goal is to get you to 28 weeks and they would be prepared to take them should they notice anything start. I remember going to my 30 week appointment and he was very happy I got there. The last 3 weeks I was in the office just about every other day and I also got the shots to develop their lungs.

Also, keep in mind, if I remember correctly only 10% of identiical twins develop this disorder and all are in varying degrees.

Good luck!

Re: identical twins - one placenta

Well I officially have TTTS - stage 1.. Right now they are monitoring me 2x a week. This week, I will go 3x just to be checked and make sure the fluid levels remain the same I went to the hospital to get a steroid shot and a stress test. I will do the same tomorrow.

I am praying that I stay the same and stay pregnant with these girls as long as possible. We take it day by day, but each week we pass is a good one!