Hi all,

I am 27 weeks today with identical (mcda) twin girls.

I had a scan on Tuesday that showed that twin one has only grown 47 grams in two weeks and is now 215g below average and 173g behind twin 2. Two weeks ago both were doing well and twin one was on the 47th percentile and is now on the 5th. She is still moving around and appears ok according to the docs.

I had a very high BHCG reading at 16 weeks for the quadruple test which suggested Down's Syndrome (which was ruled out) or potential problems with the placenta.

Has anyone experienced this at such an early stage and what was the outcome? eg early delivery, growth caught up?

I will be having a well-being scan on Monday and they have discussed the possibility of steroids and early delivery.

It is stressful just sitting at home waiting and recording kicks.

We just set up the cots on the weekend and now I am depressed just looking at them.

If anyone can help me to prepare good or bad stories I think that would help. I had a look in Babies Born Early and have some idea (as much as you can without going through it) of the long potential NICU stay we may face and the possibility of losing one or both girls.

Thanks.

Jen

I had one twin (mc/da) behind right from the start. After the 12 weeks scan the OB commented that the size difference was more than usual (I think it was around a week by then). As the pregnancy progressed my little one stayed around 3-5%, the bigger one around 70%. We were closely monitored from 16 weeks for signs of TTTS due to the size difference. At the 24 week scan my little one had only grown one week in a fortnight (i.e. she'd gone suddenly from 2 to 3 weeks behind) and one of her Doppler measurements was right at the limit of normal. The OB told us to be prepared for delivery before 30 weeks, he considered it highly unlikely that we'd get that far along though.

Apparently the babies then became a medical marvel - the little one just kept growing along her 3rd percentile and her Dopplers were back to normal. My OB and sonologist were stunned on a weekly basis

At 36+4 the little one's head appeared to stop growing and her fluid level started to drop. I was induced the next day. I have never been as relieved as I was the moment she was delivered crying and healthy. She spent 10 days in SCN until she could maintain her temperature and was consistently putting on weight and feeding well - she sucked all of her feeds and didn't need any breathing assistance. The larger twin spent 3 days in SCN. Their birth weights were 2.1 and 3.2 kg (both within 50g of the estimates done the day before).

The girls are about to turn 3, there's about 3 cm and 3 kg difference - my IUGR baby is still on the small side. She met most of her milestones around 5-7 weeks after her larger sister in the first year but is developmentally normal.

I understand where you are now, it was an extremely stressful time for us. I coped by becoming overly positive and optimistic (and asked my OB to only discuss what I had to know and what I asked about), my DH (who knew much more about the realities of prem babies) was a mess. At around 24 weeks I adopted a high protein, high fat diet (after running the idea past a sceptical OB), I drank Sustagen twice/day and ate full fat dairy, nuts etc. (there are limited studies suggesting this can help with IUGR in some cases) - it felt better to be able to feel like I was able to do something to help the babies.

After the birth my OB commented that he couldn't believe how lucky we were - I am under no illusions at all.

I hope it helps to hear of a good outcome. I hope your babies do well and don't need delivering for many more weeks.

Georgie

Just wanted to wish you the best of luck!! The AWESOME thing is that you are already 27 weeks - so the girls chances are high!! I know quite a few multiples born so early, while obviously not by choice they are doing fabulously and are happy and healthy which hospital are you going through? Take care and all the best for a good growth scan on Monday

hi whiskers - i have identical (mcda) twin girls who are now almost 3!! but the preganancy and all it's stress & worry will stay with me for a life-time i think. i would say that it is very normal for one twin to be bigger than the other? i know mine were never the same size, and still aren't! i made it to 35.5 weeks and they decided to do a c-section just because one of the twins looked as if she hadn't grown in a week or 2 but honestly it gets so hard to measure them accuratly by that stage it's not reliable. my best advise to keep them in as long as possible it to stay off your feets and sleep & rest as much as you can, every day in there is less time in nicu!! so hang in there, the end result is amazing :0)

Thanks for the fast replies

Georgie01- It's so hard to understand the stress unless you have been there. I am so please you got the miracle you hoped for.

Twinmania- I don't think the stress will ever leave me either. Congrats on the girls.

Steggles- Thanks for the support. Kind words mean so much at a time like this.

We are being seen at Monash Medical Center which has a level 3 NICU so I know I am in a good place.

I have also been keeping up the high proteins etc and have gained 13kg already plus gained back the few I lost in the first few weeks with the severe morning sickness. I am only a small person (5 foot tall) and 13 kg was what I gained with my DS at 40 weeks.

Trying to keep positive but the waiting is just killing me, I just want to see them again on Monday and see they are ok.

This twin thing is not as easy as people think. The number of times people have said to me "Oh you are so lucky to have identical twins- I hope have the same one day" There just isn't the awareness I think of the risks esp with mcda twins. I have even had someone say to me that "you should at least get one at the end". Then you explain it's not that sinple as they share a placenta and that losing one baby hurts even if one survives.

Jen

Some people are just idiots - do they not think?!??? Have you been in contact with your local multiple birth association?

Hi,

I can't help you specifically, but I just wanted to wish you well. You have gotten to 27 weeks, so that is great already!! Plus if they know that delivery could be imminent you will hopefully get steriods on board which will help! Plus your monitoring will pick up which will also be the best thing for you.

I found carrying ID twins very scary, and was frightened at every scan waiting to hear that they had TTTS.

Wait and see what happens on Monday - she might pick up, or might stay on the same percetile.....my fingers will be crossed for you...

On a positive note identical girls are wonderful!

Good luck

Not identical here but had IUGR 1st diagnosed at 26 weeks so v similar gestation to yours, went on steroids, they stayed ok until 30 weeks then emergency c-section, (with weekly then twice weekly then 3 x weekly monitoring then hospital admission)

just wanted you to know that the little one (born 920g) is now ahead of his sister (born at 1720g) in SO many things, so despite a long NICU and SCN stay (7 weeks), and despite all the higher risks of things not going well, and despite going home with one still having 3 meals a day out of 8 fed through NG tube, they are both doing really well at 3y3m.

People can be so insensitive can't they

All the very very best. Remember the chances are still incredibly high that all will be fine for you and both babies xxx

Nerissa xxx

I had my monitoring at Monash and delivered at Jessie Mac so had the Monash NICU team in the delivery room until it was clear that they wouldn't be needed. I always felt I was in great hands there. I hope that the news on Monday is good.

Nerissa, my twins are around 5 months younger than yours so I followed your story closely while I was pregnant and coming to terms with it all. Being able to read your story and follow the progress of your twins post-delivery was enormously encouraging and really helped me stay positive. Thank you for sharing.

I had DCDA twins so different than you.

I had a big bleed due to placenta previa at 21wks, but scans showed everything was fine. After my 3rd bleed at 28wks, scans showed DS#1's growth had slowed. The day before they were born, DS#1 was diagnosed with IUGR, with a weight difference of over 500gm less than DS#2 (born at 1245g & 1525g respectively).

I had been in hospital for 2wks after my last bleed (had steroids after the 21wk, 25wk & 28wk bleeds), but was allowed home on bed rest & daily hospital visits for monitoring. The next morning my water broke & I went into spontaneous labour at 30w4d. They spent time in NICU/SCN & came home at 7wks AA/ 38w4d CA.

DS#1 is still smaller in size (around 2kg less than DS#2 & around 3cm shorter), but they turn 2 in just over 2wks & so far have no lasting healthy issues (possible asthma, but not yet diagnosed), from their prematurity.

HTH & good luck.

Jules

Hi Whiskers
One of my mcda twins was diagnosed with IUGR at 20 weeks, measuring 2 weeks behind. His was due to a velamentous cord insertion, dopplers were not great with absent end diastolic flow . The doctors told us to hope for delivery at 26-27 weeks as a good outcome. Thankfully, we made it to exactly 30 weeks.
We had 17 u/s in the 10 weeks between 20 and 30 weeks, to pinpoint the right moment to deliver. It was when the flow went from absent end to reverse end.
My small twin was 890gms, his bigger brother 1490gms - a 40% size difference. They did have a long NICU/SCBU stay, of 84 and 97 days, so past their due dates, but they were quite naughty prems!
Like Georgie, I started a high protein diet. I don't know if it helped, but it made me feel better!
Today, they are 2 yrs old. There is still a size difference - about 15 cms and 3 kilos. They do not look like id twins. Send me a PM if you are on facebook if you want to see some photos. Developmentally they are perfect. The smaller twin usually has reached milestones a week or 2 behind his brother. They have had no ongonig health problems.
I hope that helps set your mind at rest, it was an incredibly stressful time. But, as another person has said, you are at 27 weeks, which is a good gestation to get too. Every day now is a bonus.

I have just brought my ID girls from hospital after a stint of 35 days in hospital. A discrepancy in their size was noted at our 12 week scan and the specialist gave us "the chat" about the possibility of losing one or both. We also were diagnosed with stage 1 TTTS at around 18 weeks but luckily for us it stayed at stage 1. We were scanned weekly and sometimes twice weekly to monitor their growth and while it was a pain going in to the hosp so often it was nice to see them on their screen.

I too did the high protein diet after hearing about it on here. I don't know if it worked but it didn't hurt either.

My girls were 600g exactly different at birth (1335g & 1935g) and that size difference has stayed the same over the past 5 and a bit weeks. Other than that the girls have done really well. I guess only time with tell if there will be long standing complications (it was suggested there might be) but we will cross that bridge when and if we get there.

I agree that I never knew that twin pregnancies could be so complicated and people don't understand how stressful this can be until you have gone through it.

I know it is hard but try to focus on the bubs and remain positive. We named ours and called them by name before birth and asked family to do the same. That way they really became "ours" and not twin a & b with a variety of complications and concerns. That's not very everyone but it helped us.

Best of luck...

heading out the door - T1 was always smaller than T2 - she was the reason i was induced as they discovered at 37w early onset IUGR with her.

monumental difference between 37 and 27w though so i'm afraid i can't be much help except ensure you are being scanned regularly - i can't believe ppl have said those things to you :(

Thank you ll for your kind words and happy endings. I go for my scan today (not a growth one though) and will hopefully get some good news. Not sure how much they will be able to tell but will see. Hopefully will be coming home and will update when I do.

Thanks again.
Jen

Good luck Jen - will hope and pray for a great outcome for you!

Good luck!

They can tell a lot from the wellbeing scan, so I hope you have good fluid levels, Dopplers and all the other things that indicate that your baby is doing well.

hi jen! everything crossed for your little family today. i have ID boys and i remember all too well those scans. trust in the wonderful staff you have and they will do all they can to keep your babies travelling along well.
i remember having the same concerns around 28 wks.... but it turned out to be false alarm. fingers crossed the scan today shows your gorgeous girls doing well.
my boys were born at 36w+4d as they were concerned re: twin 2s growth. turned out only 200gm difference. the wellbeing scan can show a lot. you are in good hands. thinking of you.

How did you go OP?

Sorry computer mouse died.

Scan went ok, they are moving and were "breathing" for a few seconds each here and there. Flow not fantastic but no worse than the last scan.

Plan is to try to make it to next week then do the steroids after the growth scan. Doc said if this had happened at 32 weeks we would have delivered immediately but she said they are just not mature enough yet or she would whip them out. She said she would be "very happy " if we could make it to 32 weeks but will take each day as it comes as that is not the most likely.

Praying they are stubborn and show some growth at the next scan and can hold out much longer.

I have packed my bag as much as I can and now just feel like all I can do is keep my fingers crossed and try to enjoy time with my toddler as the NICU journey will be tough on him too. 32 weeks is 3 days after his birthday so that is the minimum I am hoping for. 36 would be great.

Is there anything you recommend packing knowing you will be leaving without your bubs?

I have brought them a little hat each and will get them a special teddy each to go in or on their NICU/SCN isolette. Will not bother with clothes till they are bigger.

Thanks once again for your support it has given me hope they will be ok.

Jen

Hi Jen

Glad to hear things went 'ok' at your scan yesterday - hoping you can hold out for a bit longer yet until you deliver your beautiful bubs

My boys were born at Monash at 27 weeks 4.5 years ago - you are in fantastic hands there. Have you been for a tour of NICU/SCN yet? I am not sure how old your toddler is, it certainly does make it harder to visit however things that I found easier were to take a portable DVD player in - we stocked up on lots of new movies/wiggles/hi-5. Make the most of the parents room - I am hoping that it has been renovated since we were there but it had a fridge, TV and a small area for DD to play/draw in. Do no hesitate to get the keys from level 4 Childrens ward to use the outdoor playground.

They will also try and move you to your closest hospital with a SCN once your bubs are ready - not sure what your closest one is - ours was Casey, we only spent the last few days there but it was so much more relaxed and easier - we could also room in when they were ready to come home

Really hope your NICU/SCN is a short and smooth one - if you have any questions about Monash, am more than happy to try and answer them

Cheers

Kerri

Hi Whiskers - glad to hear everything is as good as it can be. I delivered at Monash almost 8 months ago now, I was in Jessie Mac but DD spent time in NICU (almost 2 weeks) before being transferred to SCN at Jessie Mac - they truely as fantastic there - you definately are in good hands. I didn't have identical twins but IUGR with DD- she was born at 1293gm at 33 +6 weeks, and DS was 2310gm. I was admitted on a Thursday and had an emergency c-section on the Saturday morning, they just weren't happy with DD, cord flow was great, she was breathing but not moving much so she had to come out. I wish you all the best - I hope things improve (fingers crossed) - the only thing I can suggest is maybe sleeping with some wraps these can be used as bed sheets for you little ones while they are in the isollette.
Please PM me if you have any questions about Monash or anything really!
Kat

An update after the growth scan.

Great news. Twin one has had a pretty big growth spurt and is catching up to twin two. They are now both over the 1kg mark. Doc was happy to try and wait till next Mon to see about steroids now as bubs are doing well. Flow still not fantastic but good enough and bubs seem happy. We are now 28 and 6 so feeling a little more relaxed about things. Hopefully all will be good on next Mondays scan and they will make it another 9 days after that (Bloody Easter) to the next growth scan. Hoping it was just a blip on the radar and that I can continue to bake them till 36 weeks. Not sure what caused the slow growth in that two weeks but hoping it will have no lasting effects.

Thank you all for your support. Your stories helped me to remain as positive as possible about the outcomes we may face.

Forgot to add thanks for all the info on Monash. Very helpful. My nearest hospital is Casey also so if needed might be transferred there one out of Nicu.

Jen

Great news Whiskers.

If your twins do come early, you should join L’il Aussie Prems. It's a great source of info & support form other prem mums.

Good Luck.

That is great news Whiskers - hopefully just a blip on the radar and you have a few uneventful weeks ahead of you. Whilst I loved NICU at Monash it is definately a place that I could have done without

If your closest is Casey we are probably not too far apart - if there is anything that I can do or answer please do not hesitate.

I am not currently a member but when my bubs were born and very little the local twin club was a great support as well

Cheers

Kerri