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Thursday, July 17, 2014

My Mono/Dis

So the boys are identical. But what does that mean? 

Twins can either come from one egg that splits, or from two separate fertilized eggs. If they come from one egg that splits, they are monozygotic (meaning one zygote), and they are identical. If you're like, duh, everybody knows this, then you would be surprised to know there are people in this world who do not.

It can be difficult to tell if they are identical while still in the uterus, but in our situation there are some clues that help us know that these boys are identical.

You're probably asking yourself, surely there is a complicated-sounding medical term for this situation. And you would be right! There is!

Our twins are monochorionic/diamniotic twins (mono/di for short), meaning there is one chorion and two amniotic sacs (the far left picture above). There are layers of the sac that a baby is in (who knew?), and the outer layer is called the chorion. Inside the chorion is the amniotic sac. So basically, they are each in their own amniotic sac, but both are together in one big sac.

Mono/di twins share a placenta. There are instances where two placentas can fuse, making it difficult to know whether they are identical or fraternal. But usually on a level 2 ultrasound you can see signs of fusing, and that is not the case here. So there is one placenta providing nutrients to both babies.

Because they share a placenta, there is cause for concern. Twin-to-Twin Transfusion Syndrome (TTTS for short) can occur in this situation, meaning one baby starts taking all the nutrients from the placenta, leaving the other baby without anything. This occurs in approximately 15% of twin pregnancies where there is a shared placenta.

SO that means that since my anatomy scan at 20 weeks, I have gone to the OU Medical Center (2.5 hours away, ugh) for a level 2 ultrasound every two weeks for monitoring by a Maternal Fetal Medicine Specialist to make sure TTTS isn't occurring. They measure amniotic fluid levels and the babies, among other things. If one has more fluid or is measuring much larger, those are signs of TTTS and they start to take action. I am also not allowed to go past 37 weeks, so these babies will be here by the last week of September.

So basically, between my visits to OU and my monthly visit to my local doctor, I have three appointments a month. Which means I get three ultrasounds a month, that is, until I reach 32 weeks, when I will be seen weekly. Where will I go? Who knows, that's still up in the air. Excellent.

And the one question I get asked so often that I really should start keeping a count is, where will I deliver? Again, that's still up in the air. There are about 837 factors that will come into play as time goes on. So your guess is as good as mine.

In all seriousness, your prayers for two healthy babies who don't steal each other's food and stay inside as long as possible are greatly appreciated. There are lots of healthy mono/di pregnancies, but unfortunately there are some that are not. So far we have been very blessed, but we also know it's a long way to September!

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