Multiples

Selective Growth Restriction

My mono/di twins are showing a 23% growth discordance. The good news, I guess, is that they don't suspect TTTS at this point because fluid levels and blood flow look good. Baby B is still growing, just consistently smaller. Doctor suspects selective growth restriction and said they'll just monitor closely. Does anyone have experience with this? I had never heard of it until today. I made the mistake of googling it when I got back from my appointment. I'm just trying to tell myself that chances are very good that I can keep these little guys in for several more weeks even if things progress. 
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Re: Selective Growth Restriction

  • My twins had both.  Is the smaller one above the 10th percentile?  What's the plan for monitoring?  Let me know if you have any questions.  I delivered my boys premature because of the smaller baby's cord flow and IUGR.  They are doing well today with still some discordance is size but both healthy.
  • SWA80SWA80
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    Doctor didn't mention percentile. I found an online calculator that puts smaller baby at 24th percentile and larger at 58th based on weight, not sure if it is accurate. 

    Plan is to check fluid in two weeks, growth in four and see where we are.

    When did you end up delivering?  

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  • image SWA80:

    Doctor didn't mention percentile. I found an online calculator that puts smaller baby at 24th percentile and larger at 58th based on weight, not sure if it is accurate. 

    Plan is to check fluid in two weeks, growth in four and see where we are.

    When did you end up delivering?  

    28 weeks. I was in the hospital starting at 24 for monitoring.  That's good that the smaller one is not IUGR yet.  I would suggest rest as much as possible especially on your left side .  Drink boost or ensure 2-3 times a day and/or increase your dietary protein intake. I would also ask to have growth rechecked earlier than 4 weeks.  They can do it as often as every 2 weeks.

  • SWA80SWA80
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    So he's not technically IUGR until less than 10th percentile? I asked about having measurement sooner but doctor said they really don't like to because it isn't that reliable. I may be able to sweet talk the tech at my next visit though since they'll already be doing a scan anyway- worth a shot. 

    Thanks so much for the advice. I've already been consuming protein like it is my job:) 

      

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  • We had both as well.  When I delivered, they could see that the placenta didn't divide evenly, so one twin had 2/3, the other only 1/3.  The smaller twins cord had some issues as well.  They delivered me at 31w6d because my smaller twin's blood flow reversed, but they had also wanted her to grow more than she had.  Definitely ask what the criteria is for delivering with a growth restriction so you know what to expect.  Despite what others often tell you, sometimes babies grow better outside, than inside.

    My littler girl is just more petite than her sister.  You can also easily tell them apart.  They aren't even a little bit identical.  On the upside, while she was born tiny, she caught up to her sister in height (not weight) by about age 4.  She's healthy and happy, just a very petite thing.

  • image SWA80:

    So he's not technically IUGR until less than 10th percentile? I asked about having measurement sooner but doctor said they really don't like to because it isn't that reliable. I may be able to sweet talk the tech at my next visit though since they'll already be doing a scan anyway- worth a shot. 

    Thanks so much for the advice. I've already been consuming protein like it is my job:) 

      

    Yes technically IUGR is 10th % and below but a discordance of 20% or more in identical twins can be concerning and monitored closely.  Good luck, FX for a big growth spurt!

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