MFM????

AJC&Maggie

So, I have not yet had my official 1st visit with my OB. I had an "urgent" 10min appt today because of bleeding with my 2 SCH's. I will meet with my OB for my first "real" appt next week.

I asked her today if I will need to see a MFM during my pregnancy because I am 35, have been bleeding the entire pregnancy and have twins. She said "no", I am not considered high risk.

Are you seeing a high risk MFM? Now I am a little concerned that I won't be monitored properly. I hear you guys talk about seeing MFM's; why are you seeing one?

Also, what is the typical monitoring (ultrasound screenings) for a twin gestation?

Thank you Girls!!

AJC&Maggie

p.s. I love my OB and she is highly regarded at my hospital, so I feel very comfortable with her. I am just nervous about the twin thing.

kari.sandall

My OB was a MFM doctor. I saw him because of my ectopic history.

PinkinProvence

Ummmm, a twins pregnancy is automatically high risk and there should be no question that you at least consult with an MFM, if not see one exclusively.  If your OB doesn't understand that or is not on board, I would be looking for a new OB immediately.

nblondheim

I see a perinatalogist and my OBGYN but that is all. I was seeing them every 5 or so weeks until I came up with concerns. I now see the perinatalogist every week and my OBGYN every two weeks.

jezebel57

i would DEFINITELY consult with an MFM.  if no further monitoring is necessary, than fine, but at least then you would be sure.  you've worked too hard to get here to not get the best care.  ask for a referral! 

PinkinProvence

As for typical monitoring -

I had 3 US with RE before I was released to MFM.  I then had a 9 week US with MFM, along with an initial appointment, genetic testing and a ton of blood work.  I had my NT scan and NS bw at12 weeks.  I had an appointment with RE at 12 weeks with a mini US to hear see heartbeats.

From 16 weeks to 26 weeks, I had an abdominal (to check babies) and transvaginal (to check my cervix length) US every other week, along with an appointment with the RE immediately following. My A/S scan was at 20ish weeks.  I had growth Ultrasounds every 4 weeks during that time, along with GD test.

Since my cervix started shortening at 26 weeks, I began weekly appointments, with abdominal and transvaginal ultrasounds each time.  I had several fFN during this time.  Growth US remained every 4 weeks during this time.

At 33 weeks, I began internal cervical checks by the doctor and continued abdominal ultrasounds weekly.

daisy19782011

I am, but mostley b/c mine are MOMO.

kzawisl

I saw a perinatogist as well as my OB *frequently*. Unless your OB is an MFM, I'd see one.

marcobonny

I've never seen a MFM my whole pregnancy. I don't believe that carrying twins is "high risk" anything could go with any kind of pregnancy. I'm 25w5d and everything has been going great with my pregnancy. I wouldn't be concerned...

katekat8721

Hey girlie! I just had my first obgyn appt today. I'll only see a MFM if well, something goes wrong or something needs a bit closer monitoring. At 16 weeks the obgyn reassesses to see if I should be transferred. But the obgyn/MFM dept works closely together and my obgyn seems knowledgeable with twin pregnancies, so... I dunno!

My obgyn says that they see you about 1x/month and that once you hit 24 (I think, I forget exactly) weeks they see you 2x/month. At 26-28 weeks she generally takes people off work, which seems a little early to me. Should things require closer monitoring they will make exceptions and see you sooner.

I have an SCH too (boo) but am going back to my RE Monday to have him check it. My obgyn wasn't overly concerned with it at today's appt.

It's weird going to see an obgyn after being babied by the RE

curlylocks3

I am not, but I'm in a unique boat. 

I had a preconception consult with MFM 2.5 years ago before TTC so we could make a plan for treating my clotting disorder. I asked my OB at my first appointment if I needed one and she said no, but she'd refer me if I wanted for a consult. I know the plan she laid out (cervical exams, growth US every 4 weeks, NSTs, early GD test) is in line with MFM recommendations and that my OB has taken care of tons of twins.

I wasn't 100% sure if I should have one so I asked one of our MFM's at work his opinion. He asked which OB group I'm with and when I told him he said I'd be fine with them, others he would recommend it. 

Personally, I'd ask to have the consult.

zazu13

My OB also said that I was not high risk and didn't need extra monitoring. I do believe him, given that my twins are di/di and I have no health concerns that I know of, but that was still not good enough for me and DH. We worked too hard to get this far and we are overly concerned about things going wrong. Our MFM office would only schedule an appointment with a referral, so we had our RE send in the referral and we transferred to being monitored by the MFM exclusively. We are much happier. Do what you feel comfortable with. 

AJC&Maggie

This is great information girls! I really appreciate all your responses. There is so much to worry/think about!! I will ask more questions at my appt on Tuesday. Thank you!!!!!

Mrs. Alice

Honestly, I would be pretty wary of an OB who didn't consider twins high risk. I think consulting with an MFM is a good idea in any multiple pregnancy. How often you see them would be dependent on how risky your pregnancy is and if complications occur. Someone above said they don't think twins are high risk because anything can go wrong in any pregnancy. The whole definition of high risk means there's a higher probability with it happening when you are carrying more than one. That's fact. You only get one chance to carry these babies so I would personally take every precaution.

Stephanie2167

I'm having di/di girls and have seen a MFM every 3-4 weeks since my anatomy scan at 18 weeks. My pregnancy has been pretty uneventful, a few little hiccups here and there but nothing crazy. I think it is super important to have the extra monitoring. I'd ask your doc for a referral to see a MFM as well.

I see both my OB and MFM. Currently at 34 weeks I see them each once a week. 

whitehousem

I think people (including docs) have different opinions about what it means to be high risk vs needing extra monitoring. My OB immediately referred me to MFM bc they thought I had mo/do twins. I practically had to fight with MFM to get an early appt to confirm mo/di, which they did. MFM said they don't consider all twins high risk (with that being said, they do require additional monitoring). I will go to MFM every two weeks from 16-26weeks then every weeks, plus regular OB schedule. I would not be going this often if not mo/di. I would def recommend seeing a MFM at least for an opinion as to what kind of care and monitoring you require. Oh and MFM would not have seen me until at least 20 weeks if it wasn't for mo/di.

jennylryan

I have not seen a MFM and won't unless there are complications. I am monitored closely by my OB who has experience with twins. Every doctor is different and I trust what mine is doing for me and my boys.

maribelleNS

I see MFM exclusively, though my case is definitely in the unique category. I was referred to MFM before we even found out i was carrying twins due to being diagnosed with cancer early in my pregnancy. My OB/GYN was fantastic, but she felt given the complicated situation MFM was the best place for me to get specialized care.

Went for my first ultrasound and MFM appt and surprise, it's di/di twins lol. Funny how that worked out honestly.

I think normal practice where i am is to treat all twin pregnancies as high risk and to have some consultation with MFM, with continued involvement from your OB.

If you're concerned, it can't hurt to ask or request an MFM consult.

KatieGummow

I am di/di and am considered low high-risk, but high-risk none the less.  With multiples the chances of preterm labor are much higher (among other issues), which is why we are all in the high-risk category.  I go to an MFM for imaging once a month starting at my anatomy scan (well, I did NT, so starting then), and I have to see them once a month.  They don't deliver, so my OB will still be my captain.  

My OB also does ultra sounds, but not on the same super fancy equipment the MFM team have.  They give each other results and discuss what needs to be discussed.  Is your OB a multiples specialist?  I didn't have a choice in the matter of seeing an MFM, my OB said (in not so many words), "Congratulations, it's twins!  Here is a pamphlet of the place you will be spending a lot of time at."

cukimerrydoll

If your OB specializes with twins, than your pregnancy may not be considered high risk based on their normal baseline, but in general these are always high risk. That being said, my OB specializes with what she calls "lower risk multiples" - still high risk, but no additional complications. I'm now also seeing a MFM since a TTTS diagnosis, but without the additional complications I would have been happy sticking with my regular OB since multiples are her specialty. Many MFMs in my area require a recommendation, so you may want to ask which MFM practice you'd be referred to if needed and under what circumstances.