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.

Via

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!

Was this spontaneous twinning?

This is what one of my doctors asked me at my last visit. Yes, one of my many doctors that I see.

Twins do not "run in my family" (that's a different post for a different day), and we were not doing fertility treatments of any kind. So yes, I think spontaneous is the word.

Upon our shock of learning we were having twins, I started devouring information about multiple births. The likelihood of having twins, the types of twins, possible complications, etc. It turns out that your likelihood to have twins increases into your mid-30s. Your body is basically in shut-down mode and is just throwing eggs out. 

Seeing as I am 34, I thought this was the case and that we were having fraternal twins (two eggs = two separate everything = fraternal twins). I would think to myself, this would have been good information to have when I was trying not to have babies in my 20s.

We knew from my very first appointment at 10 weeks that they had separate amniotic sacs. There was a very clear membrane dividing them, which was a big sign pointing to fraternal twins. Still, I had this nagging in the back of my mind...

With twins, you get an ultrasound at every doctor appointment to check their heartbeats. At our 16 week appointment my doctor said maybe one was a boy but it was too hard to tell what the other one was. Okay fine.

We thought we knew exactly what was going to happen at our 20 week anatomy scan. We expected to go in and hear that we were having one boy and one girl. We already had one boy name and one girl name and it would be perfect. 

Our ultrasound tech first asked if anybody had told us what kind of placenta they had. No, nobody had mentioned it and I hadn't asked yet. But I knew that the placenta was a big factor in knowing what kind of twins they were. 

Then she said, surprise, it looks like two boys! Shock! Two boy scouts for Todd! Hooray! And then surprise, they share a placenta! More shock!

A shared placenta, with no signs of two placentas fusing, means one thing. IDENTICAL TWINS. Identical boys to be exact. It's pretty much the last thing I ever expected to hear. 

Spontaneous means coming or resulting from a natural impulse or tendency; without effort or premeditation; natural and unconstrained; unplanned.

I think it's safe to say this was definitely spontaneous twinning.

This is not a drill.

So I've been MIA for a couple months. I apologize, but there's good reason.

That's right -- I'm pregnant! But wait, look closely. Yes, it is what you think it is. We are having TWINS.

I will answer the first two questions that came to your mind: 1) no, twins don't run in my family; and 2) no, I wasn't taking any fertility drugs. This is ALL NATURAL PEOPLE.

Through my research I have discovered that your chances of having twins goes up in your 30s. Excellent. The moral of the story is that it can happen to you too!

So what does this have to do with the blog? For the last two months my one goal for the day has been to have enough energy to keep Scarlett alive. I was so exhausted I couldn't do much else beyond that. But the first trimester is over and I can feel my body waking up. Hooray!

Speaking of Scarlett, what did she say when she heard the news?