After reading the public/private thread below, I thought I would post a new discussion to get some opinions.
My SIL is currently 16 weeks with identical twins in the same amniotic sac. A thin membrane was possibly detected at a 10 weeks scan, but not definate, so she has been advised that there is a possibility that TTTS could occur at some point.
She is currently having fortnightly scans at a private OB's office in Newcastle - who is well recommended, and at the top of his field with current technology and equipment. But it is costing her over $200 per scan - she has just reached the safety net, but it is still going to be quite expensive over the course of the pregnancy.
Does anyone here have experience of the high risk clinic at John Hunter Hospital ? Will fortnightly scans be offered to her in the public hospital system?
She is expecting to deliver at JHH hospital anyway, she only has the lowest level of private health insurance, so probably won't use it - although this would ensure she gets the OB she is seeing for her scans. (This is a different OB that she saw at the start of her pregnancy - I think I have convinced her to use the scan OB for the rest of her pregnancy because he is so well regarded in his field).

Actually - while I was posting this I was googling her OB - he is actually the head of Fetal/Maternal Medicine at JHH - so I guess he would be the only doctor you would want to be seeing !!!

So I guess my qn is - if she books into the high risk clinic at JHH - he will still be responsible for some of her care, and overview of her scans ? Will she still be offered fortnightly scans ?

He has also told her that TTTS only occurs between 16-26 weeks, and she won't need fortnightly scans after this ??? I was under the impression that it could start at any time after 16 weeks. She could have misunderstood him, so I am off to google as much info as I can on it for her, but any adivce and experiences you guys have got would be great.

Many thanks,
Nicole

Sorry I can't help with the question regarding the hospital.

My girls are ID & I went public. I had scans every month (from memory). My OB said from 28 weeks I was to have fortnightly scans to check bubs growth. I was under the impression that TT can occur anytime during the PG. My girls shared a placenta but had separate amnions.

There a few ladies here that have some experience with TT.

Hope I've helped in some way.

Belinda

Thanks for that Belinda - I know her twins share a placenta, and it looks like they have separate amniotic sacs, so she is just playing the waiting game - hanging out for her fortnightly scans. I know there is no way she will book into the hospital clinic if the scans are going to drop back to monthly though !
Do you mind if I ask though - did your twins develop TTTS ? And was this the reason for their early delivery ? At the moment this is the main focus, and other complications that might occur have been pushed into the background with this hanging over her....
Many thanks,
Nicole

Hi again.

My twins were born early b/c they decided they wanted to come out LOL. We didn't have any TTS prob's at all.

From what I can remember, I thought my OB said the risk of TTS got greater as the PG progressed. There are some other ladies here that have more experience with TTS though.

I can't even remember how often I had my scans, but I know it wasn't fortnightly until about 28 weeks. I think if there were any sign or question about growth etc, they would have been more regular.

I hope I've helped & I hope someone else can better answer your questions.

Belinda

Hi Nicole. Thank goodness you've found out they are in seperate sacs. It is much better. funny enough so many people still think identicals have to be in the one sac otherwise they are frats when the truth is only 1-3% of identicals share the one sac - thank goodness.

Anyway enough of that! lol

I had my ID twins at JHH. I hated with a capital 'H' the hospital but thought the head guy, which I beleive the one you speak of and the one I know are one and the same, is fantastic. he is a truly wonderful doctor/head of the hospital.

I had scans fortnightly, then weekly, then every day. though that was down on the central coast. my twins had stopped growing that is why.

I wish your sister the very best.

hi!

I was worried about TTTS throughout my whole pregnancy as they had discordant growth. They shared a placenta and blood flow was abnormal to one of them (one was being greedy probably!!)

But thank goodness TTTS did not develop. I did however have weekly scans from wk 19. At wk 32 the smaller twin had stopped growing so it was time to take them out.

I think the most important thing is to have a good OB, get very frequent scans, and if it does develop there are treatments available now which are quite successful. Dont be like me and google all day about TTTS cos what you see on the internet are mostly the unsuccessful stories - the ones that didnt make it. It made me so sad and worried...When I stopped doing that and developed a more positive attitude, I felt better that I was being fairer to the twins that were inside me.

One still has a worried/confused look on his face though!! LOL!

Good luck, xxx Ali

Hi :-)
She's lucky to have you looking out for her.

I'm 25/40 with ID boys, and like the others I initially tortured myself with too much information! The internet is a very mixed blessing.

I asked my obs about the TTTS issue (he's the head of the Multiples clinic at the Women's in Melbourne). It CAN develop at any stage, but if it hasn't shown up by the time you reach 21, it "won't" be a seriously bad case (i.e. wouldn't require surgery during pregnancy, or absurdly early delivery).

But there IS still the issue of monitoring the twins' growth, so she'll still need scans later on.

I've been having 3 weekly scans so far- and no TTTS, thank goodness. My obs printed out all my requests at the first appointment, and he stopped at 31 weeks- I expect the routine will change then.

It's funny, but I never once considered doing any type of research online when I found out I was having twins. It just never crossed my mind! I never gave having twins a second thought and didn't concern myself with anything whatsoever. odd yes. lol

Everything came as a big surprise to me. lol even when I go for a normal scan one day to be told I have to have them that day. That was at nearly 30 weeks and I still didn't have them for a week after that because no hospital wanted me. Three hosptial turned me away because of thier size. so much for emergency C-sections. lol

Thanks so much for your replies....
The research I did yesterday pretty much confirms what you guys have said - if it develops before 26 weeks it is classed as Level III, before 32 weeks it is classed as Level II and after 32 weeks, level I - with variations on individual basis. I'm guessing her OB has told her she needs to get to 26 weeks with closer observation for this reason. So our whole family have our fingers crossed for her that nothing goes wrong - she is in the best possible hands anyway - she just needs to make the decision whether to book into the public hospital clinic, or continue seeing the fetal/maternal specialist privately until delivery time.

Once again - thanks so much for your advice - I'm sure I'll be back here asking about some other thing sooner or later !!!!
Nicole