As of today I am 25 weeks pregnant with my little twincesses!
I had meant to post an entry right at 24 weeks, because that is a huge pregnancy milestone: viability! What this means is that if the babies were to be born prematurely, they would have decent odds of survival. Most hospitals will not even resuscitate a baby born prior to 23-24 weeks, because their chances of survival are so low. I’ve seen different viability statistics from various sources, but it appears that a baby born at 24 weeks has somewhere between a 40-70% chance of survival. I’d been counting down the days until we reached 24 weeks, because our chances of ending this pregnancy with two live babies in our arms would increase.
At 24 weeks 1 day, I saw my MFM for our biweekly ultrasound. Not only would they be checking for signs of Twin to Twin Tranfusion Syndrome, but this time they would be measuring the babies’ growth (something that they do every 4 weeks), and doing a fetal echocardiogram to look closely at their hearts.
We had my favorite ultrasound tech, who is also one of the midwives. She has known me through my previous three pregnancies, and always made a point to come see my babies while we were in the hospital. I love chatting with her when she does my ultrasounds. This time, she began by doing the echocardiogram. She first looked at Baby A’s heart, then Baby B’s. I was watching closely, since I’d had a feeling something was “different” about Baby B’s heart somehow. This time though, I did not see anything that looked distinctively different from Baby A’s heart, and the tech assured me that she hadn’t seen any problems with either baby. That was a huge relief!
She checked the deepest vertical pockets of fluid around each baby. This time they were 6.8 and 4, which is the biggest fluid discordance we have seen so far, but not a big concern. TTTS is diagnosed when one DVP measurement goes lower than 2 and the other goes higher than 8, so we were well within the safe range.
Next, she measured the size of the babies. This is done by taking measurements of head circumference, abdominal circumference, and femur bones, then averaging those numbers to get an estimate of gestational age and weight. All of the measurements were within a few days of the babies’ actual gestational age. I noted that both babies had heads that measured larger than their gestational age, and both babies had femur bones that measured smaller than their gestational age. This means they will most likely be built like all my other kids: with short little legs, and big brains. LOL!
Both babies were estimated to weigh 1 lb 6 oz each. According to the weight charts for gestational ages of twins, the average size for 24 week twin babies is 1 lb 7 oz, so my babies are pretty much right on track! I was thrilled to see that they were measuring exactly the same size, which indicates that they are sharing their one placenta well so far. Twins practically never weigh exactly the same at birth, so I expect as I get further along we will start to see slight variation.
After a great ultrasound, the MFM came in to talk with us. He was wearing a mask and losing his voice, so we talked only briefly. He again told me that my daughters look “perfect.” When describing their growth, he said “Baby A is 1 lb 6 oz, and Baby B is….1 lb 6 oz. You can’t get any better than that!” So I left feeling like a rock star mom, with rock star twins. I can’t even describe the feelings of pure relief and elation that follow a good appointment.
The following Monday, I saw my regular OB, whom I have been seeing once per month. I had to do my glucose tolerance testing, which is always a chore. This test requires you to drink a bottle of “glucola,” which is like a very syrupy, sweet, flat soda. Then you have to wait exactly one hour, and get your blood drawn to test your blood sugar levels. Basically they want to see how well your body can process sugar. In my past pregnancies, I had always passed this test with flying colors, but gestational diabetes is more common with twins. I just got my results today, and I did, in fact, pass, so luckily I do not have gestational diabetes.
After I had my blood drawn for the glucose test, I met with Dr. Northshore. First he measured my uterus, which was apparently measuring 32 weeks – at only 24 weeks! He then checked the babies heartbeats, and based on location, confirmed that Baby A was still vertex (head down) and Baby B was still breech (head up). Of course, I knew this, since Baby B’s head is constantly pressed against my right ribs! The OB had reviewed my ultrasound records from the MFM, and also complimented me on how well my babies are growing and how well they are sharing with each other.
I had a discussion with Dr. Northshore about something the midwife had flippantly mentioned during my ultrasound. She’d said that if the babies come early, they will need to go to a different hospital that has a level 3 NICU. I hadn’t realized that the “special care nursery” at my hospital isn’t technically a NICU.
The OB said that the special care nursery can take care of babies that are born 34 weeks or later. If the babies come prior to 34 weeks, they will need to transfer to the other hospital location, in a larger city about 30 minutes away. Or, if we know ahead of time that they will need to come earlier, I should actually go straight to the other hospital and deliver them there. Unfortunately, in that scenario, they would be delivered by a different OB that I have never met….no bueno. I don’t deal well with changes, or surprises. I would much rather have my twins delivered by my OB, whom I have gotten to know and trust.
This is just yet another unknown, in an entire pregnancy of unknowns…
I’ve now made it my personal goal to make it to 34 weeks, so I can stay at my familiar hospital, with the doctors and midwives that I love. I mean, I’ve always had every intention of trying to keep the babies in until as close to 36 weeks 6 days as possible, but now I have a milestone in my head. I simply MUST make it to 34 weeks. We shall see what happens! Dr. Northshore urged me to try not to worry about things I cannot control at this time, so I am trying to take that advice.
This pregnancy has been such a rollercoaster. I’m prone to anxiety by nature. I’m also a huge information gatherer. From the day I found out I had two babies inside me, I have been relentlessly researching. The statistics on monochorionic twins (identical twins that share one placenta) are scary, to say the least: 13% of monochorionic twin moms experience the loss of at least one baby by 24 weeks, 15-20% of monochorionic twins develop potentially fatal TTTS, monochorionic twins have ten times the rate of congenital heart defects, 34% of monochorionic twins have at least one fetus with interuterine growth restriction, roughly 85% of mono-di twins require NICU care. So far, my twins have been doing incredibly well and defying all odds, but still….I worry.
As time goes on, and I gather more good appointments and ultrasounds under my belt, the worries lessen…a little. Now that my babies have reached viability, I feel slightly more confident that I will give birth to two live babies. If any problems arise, like the sudden onset of TTTS, or interuterine growth restriction, I trust that my medical team will know when it’s safer to deliver the babies than for me to keep them in. Unfortunately, I know all too well that twins can be lost at any point in a pregnancy. Unexpected double stillbirths are common. I see these situations every day in the mono-di twin groups, and they are heartbreaking.
In addition to these worries, as my pregnancy progresses, other worries are popping up. It’s becoming more “real” – I am going to have TWO BABIES. I will have to deal with two newborns crying simultaneously….plus 3 other children. I will have to learn to tandem nurse. The logistics of everything, just getting two babies – plus the other kids – out to the car, how should I do this? What about shopping trips? What about doctor’s appointments? What about all the running around I do every day, to take the older kids to school, therapy, IEP meetings, extracurriculars? It will all be complicated by two babies. Simply put – I AM SCARED.
I know that I will figure it all out somehow. We will eventually settle into a routine, a crazy, hectic, never not busy routine. But man, it’s going to be HARD. I will cry many tears. I will wonder why me? I will be beyond exhausted. But I will also be surrounded by the love of my husband and our five beautiful children.
I hope that love will carry me through the hard times. I hope I won’t fall into post-partum depression. My family needs me at my best.
But there I go again…worrying about things that I have no control over right now. *sigh*
Let’s think happy thoughts. How about some pictures?!
Here are my babies at 22 weeks. We got great shots of each baby’s face at that ultrasound, and I love that they already look so much alike!
And here are the babies at 24 weeks. It is getting much harder to get good pictures, since they are already getting quite squished together in there!
And now, the ever-growing twin belly! Since I am measuring 32 weeks, just for fun, I wanted to compare to how I looked at 32 weeks with my last baby. Pretty close to the same size, but maybe just a tiny bit higher this time. I am a little scared of how big I am going to get by 36 weeks – EEEEEK!