Seeing a peri?

Million$$Baby

Yesterday I had another u/s with my RE. He told me that I'll see him Monday for one more u/s then graduate to the OBGYN. My RE shares a practice with an OBGYN office so my RE is going to refer me to one of his colleagues with a lot of multiples experience. He said the OBGYN will consult with a peri on my behalf during my treatment, but I won't see the peri unless necissary and he said there are no peri's in the area that also deliver. Does that sound right? Did you see a regular OBGYN? Thanks!

FaeryStarGazer

I never saw a Peri. I was only ever treated by my OB and he was wonderful. Got me to 37w!

FeistyFille

I see a regular OB, and she has also referred me to a peri.  At this point, I'm just getting regular ultrasounds at the peri's office to check the babies' growth, but next week I'll also start seeing a nurse every week as part of their multiples program. 

Rose.9.6.03

With triplets in particular, I would expect to be regularly seeing a peri (whether exclusively or in conjunction with an OB). 

I saw a peri exclusively and he delivered my girls.  But I know that many peris don't do L&D. 

Personally, I'd be leary of an OB that said you'd only see a peri unless necessary with triplets.  I'd also do some serious questioning as to what "a lot" of multiples experience is.

Cath&Brian

I had an appointment with my OB every 4 weeks, and saw the peri she referred me to every 2 weeks. ?Every 4 weeks I got a growth scan and the alternating 4 weeks they did a cervical check. ?My peri has been a godsend. ?In fact, when I ultimately was put on bed rest, it was due to a shortened cervix, which my OB may not have discovered. ?Every time I had a "multiples-related" question and I asked my OB, as good as she is, she never had the answer I'd read or heard, etc. ?When I'd ask my peri he had much more detailed responses. ?Especially with triplets, I HIGHLY suggest you find a peri who will see you. You're high risk, and you need to be seen by as many people as possible. ?It has always been so reassuring to me that so many people are keeping a close eye on me.

Congrats on your triplets and good luck!!?

Million$$Baby

Hmmmm...thanks! One more question - at how man weeks did you start seeing the peri?

pea-kay

how are you doing?

you definitely need to see a peri. i thought i would see my OB primarily, and see a peri every so often, but it became clear at about 22 weeks that my OB couldn't handle a triplet pregnancy, so i transferred my care to a peri exclusively, and that was absolutely the best decision. an OB just isn't going to have the experience with a high risk pregnancy that a peri will. 

as far as not having peris in the area that deliver, i'd do some calling and asking around. i kind of doubt that's true unless you live in a rural area.

 

pea-kay

and no offense to our lovely lovely twin mamas on here, but a triplet pregnancy is a whole 'nother ball of wax. twin pgs are far more common, and can be successfully handled by an OB only, but i really wouldn't risk a triplet pg with that treatment. just my opinion.

MetalMonkey

I saw both an OB and Peri but that is common practice for my OB office.  The Peri just performed growth scans but that was it.  The OB delivered me at 38 weeks (induced).

april062604

i started with my RE, then to my OB/GYN and then went into PTL at 19 weeks and went to weekly peri visits. ?my OB was kind of on the sidelines and kept informed...but didn't do anything till the delivery. he and the peri worked together, but i mainly saw the peri (who doesn't deliver). ?i would think that with trips you should see a peri. ?just my opinion...HTH. ?just noticed you're in NJ. where are you? ?where are you delivering? ?i did my IF at saint barnabas and i delivered there too. they have an outstanding NICU. ?

april062604

no offense taken. ?i totally agree!!! ?as far as peris not delivering...around here i think it's mainly due to the HUGE cost of med mal insurance for the OB part...HTH.

seattlestef

I am seeing my regular OB every 4 weeks and a MFM every 4 weeks. We started seeing the MFM at 8 weeks and will continue throughout the pregnancy. All of our U/S, growth scans, etc happen with the MFM. It seems like a lot of appts, but I feel well taken care of. My pregnancy is on the lower risk side for multiples. The babies are in seperate sacs with seperate placentas, but things can change fast and I'd think with triplets you would need to be watched especially closely.

Million$$Baby

april062604:

i started with my RE, then to my OB/GYN and then went into PTL at 19 weeks and went to weekly peri visits.  my OB was kind of on the sidelines and kept informed...but didn't do anything till the delivery. he and the peri worked together, but i mainly saw the peri (who doesn't deliver).  i would think that with trips you should see a peri.  just my opinion...HTH.  just noticed you're in NJ. where are you?  where are you delivering?  i did my IF at saint barnabas and i delivered there too. they have an outstanding NICU.

My RE said that St. Barnabus had very good peris/NICU, however I'm in Hamilton so really not near there! I'll probably deliver at Mercer/Capitol Health Systems, which supposedly has a very good NICU as well.

ChiBride2007

I am only seeing an OB, who has a lot of experience with multiples and has been great thus far. However, even my OB said he ALWAYS refers triplets to a Peri/MFM. He said, as Peakay did, that twins are higher risk, but still much more common that trips. With triplets there are far greater risks and complication potential so I would highly recommend seeing a specialist.

Katie Pittenger

I went to a Peri starting at 20 weeks and went every 4 weeks for a growth scan. This is protocol at my OB's office as well. However, my peri never checked my cervix vaginally. Everything was normal when I went to him on a Thursday and then my Monday appt with my OB my cervix was almost completely gone. That got me transferred to a hospital in Fort Worth where I now see a Maternal Fetal Specialist every week and he will deliver me. I loved the feeling of having so many eyes on my as well! Good luck!

Kim777

I see a high risk OB with lots of multiples experience, so I will only see a peri for a targeted u/s around 22 weeks to rule out a birth defect that my son has. Or he will refer me if unexpected problems develop. Instead of alternating back and forth between him and a peri, he will see me every two weeks. If I was having triplets I would definitely want to see a peri on a regular basis though. Even if there weren't any who would deliver, I would still want to go for the extra monitoring throughout my pregnancy.

susanb

Red flags! Sorry - but this is one thing that drives me nuts. While I'm sure your RE and even the OB mean well... If the doc is not a peri - he/she is not a peri! A Peri/MFM has more years of training and experience with higher order multiple births (triplets and up).  These pregnancies present risks that other pregnancies do not. If you do not have the training to recognize these things and treat them - you jeopardize the pregnancy...no matter how well meaning and how well trained/experienced you are in the area you work in.

Would you want your family doc or your cardiologist to handle you after a heart attack? kwim? Same thing - the generalist or the specialist? 

With Triplets you need the specialist. They may not deliver the babies - but by the time it gets to delivery you're back to basics. The pregnancy itself is what needs to be managed day to day by an expert. I'd demand a personal consult with a peri. I'd then ask that person to manage your pregnancy and keep the OB in the loop - not the other way around. Even if it means switching practices.  I can't tell you how many times I've seen people mislead and have complications overlooked with horrible results because an OB or High Risk OB thought they knew enough. 

MOST (mothers of supertwins - mostonline.org) has a lot of good info on this subject.  They also have people you can talk to directly on it that will give you all kinds on info. I suggest you check it out. Good luck!!! Welcome to the triplet club!!!

jennyvag

I see my OB every 4 weeks. I saw a peri at 16 weeks and will continue to do so every 4 weeks until further notice.  Honestly, I know a lot of women who have had great peri appointments -- but the first time I went, I literally met with the man for 4 minutes (story in my blog).  It was a strange meeting and when I meet w/ my OB again on Monday, I'm going to ask him for another peri recommendation b/c I'm not happy w/ mine.  GL :-)

MamaChis

I only saw an OB once at my first appointment, after that I saw a Peri from weeks 14 - 36. ?I saw the Peri every 2 weeks until week 32 then I started going weekly. ?My peri delivered my triplets as well.

I personally think that seeing a peri during a triplet pregnancy is a necessity. ?They are better prepared to give you the care and treatment that you will need. I hope that you can get a?referral.

amygdala

I agree 100% w/susanb. ?You need to be seen by a peri. ?I saw a peri exclusively & I was only pg w/2. ?I had some unexpected complications arise, & being seen by someone highly trained & experienced made all the difference, possibly even between life or death. ?You absolutely need a peri. ?

Jen&John2005

I'm seeing both my OB/GYN and my peri (mostly u/s for growth of the ID twins).  My peri doesn't deliver either, but I find it odd that your OB/GYN would not also send you to a peri even if the OB/GYN is the one who ends up doing the actual delivery, especially with triplets.

ancjph

My ob/gyn did the same thing that your re said. The peri did my growth scans. But I will say that my ob's wife was my peri, so that didn't hurt either. My office had deliver triplets before and lots of twins.

tripletmom

YOu need to see a peri. I know that i a lot of these twin moms where fine with out seeing one, but you have triplets. I started seeing mine at 22 weeks, which i feel was really too late. I should have started to go sooner, not because i had major complications, but i feel like my ob should have given me more restrictions on work and staying off my feet.

I know that my peri that delieved me, no longer does do l/d they are only there on consult, but for triplets they still maybe the one to deliver so i would ask when you go and see them.

 

ancjph

I wanted to say that my DH grew up around Hamilton area.

Lani Lyons

I was referred by my regular OB to a different "regular" OB that specialized in multiples after my first tri. Then I saw the OB and a Peri from that point on. I saw the Peri monthly for a while, then bi-weekly towards the end. The first peri I was referred to, I didn't like so I switched to a different office (that was located by the hospital I delivered at.)

 I don't think many peris deliver. The OB office I went to let me put down my preference for who I wanted to deliver, but I think they knew the chances of that person actually delivering were small. The person who ended up delivering me was someone I had never seen before, but, she did a great job so I didn't mind.

With trips, you are DEFINITELY going to want to see a peri. The peris do the more indepth ultrasounds (with better pictures:) and those were the appointments I really looked forward to for reassurance that the babies were ok.

Sorry for the long answer! But bottom line, I saw both, and I liked that. I was pretty nervous about everything for the whole pregnancy and it was that much more opportunity to be reassured that everything was ok.

Million$$Baby

Thank you all! The info I have is just what the RE gave me - I haven't seen the OBGYN yet, but when I do I'm going to talk to him about seeing a peri simultaneously. I beleive my RE said that was possible if I wanted but I need to find out more information. I will definitely plan on seeing a peri though, even if I need to find one myself. Thanks again!

Mrs.McJeep

I saw a OBGYN and a peri, but they worked together.  Basically the peri had a super awesome u/s machine and I had all my u/s there, just easier with 2 babies to use it.  My OBGYN was in the process of getting super awesome u/s machine haha.  But they consulted with each other constantly and when my water broke they both came in to see me.  But my OB was the one that delivered the boys.  Really only used the peri for his u/s machine and the 2 times I ended up in the hospital, he ended up being the one to come see me, but only because he was already in the hospital those times.

littlewonders

Just to add my own 2 cent: I was supposed to have a relatively uncomplicated identical twin pregnancy, but if I hadn't seen a peri who diagnosed our TTTS early, I doubt our babies would have made it. Identical twin (w/ shared placentas) and especially triplet pregnancies are just a little more high risk, and there definitely is a big difference between good ObGyns and docs who deal with (higher order) multiple pregnancies. My first appointment was at 9w, right after I got released from RE.