When to worry about TTTS?

IAM4UK

At my 14 week ultrasound there was a 7% discordance between the two babies. We were warned of TTTS if the discordance gets between 20-25%.

Well, at my ultrasound this morning the discordance was 15%. So over the course of 4 weeks, it's doubled. I don't have an appointment with the doctor until Sept 3rd to hear what they have to say.

I know that ultrasounds can be off on measurements, but just wondering if anyone had a high discordance and everything turned out to be okay? They are diamniotic/monochoronic (I think I got that right?)

Also, do you think my ultrasound techs are lazy and won't tell me the gender yet? I've had 3 ultrasound this month and not one tech will me what the gender is. They are identical so you just have to see it on one baby! Everyone keeps bugging me about gender and I want to know so I can start planning. Are my babies really being that stubborn??

pea-kay

Frankly, I'm shocked you're not seeing a doctor for three weeks with a discordance like that. Well, the fact that it's grown, you know? That does not sound right to me. You're seeing a peri/MFM, right?

anna2006

I agree with Pea-kay, I hope you are seeing an MFM soon.  If not, get a referral this week!

As for the gender, the techs are being responsible, not "lazy" - many offices have a policy that the tech is not allowed to tell you the gender until the doctor has confirmed it.  And many docs won't confirm it this early - you are only 17 weeks!  My MFM wouldn't say until 18 weeks.  So don't feel like you are behind - most people don't find out until 18-20 weeks.  You'll find out very soon! 

txdaisygal

I agree with Pea-Kay. When my twins reached a % discordance in the 20s we were scheduled for a f/u ultrasound for the next week, and then every two weeks until delivery. Ours started showing discordance around 27/28 weeks (can't remember exactly) and we delivered at 34 weeks with a 44% discordance...perfectly healthy girls other than the size difference.

When we started to worry about TTTS, at our 20w u/s, it was due to low amniotic fluid. At that point my MFM scheduled us for a f/u the following week. The fluid level got better, but was still low, so we had one two weeks later. In the meantime he immediately started talking to us about possible treatment options. If they're legitimately worried about TTTS I'm very shocked that they're not being more aggressive considering the potential severity of the condition. I would follow-up with your Peri and express your concerns.

parkit2010

My doctors warned me of TTTS at 17 weeks, when we had an intermittent diastolic flow in the cord on twin B. Since then I have been in every week (I'm now 25.5 weeks). While we have never been diagnosed with TTTS we have had variances in size and amniotic fluid levels. You should ask for a referral or for more frequent ultrasounds as soon as possible. Some options to reverse TTTS (especially the laser surgeries) cannot be done after 24-25 weeks, unless there are special circumstances, so being monitored and getting refered as necessary are critical. I'm sure you may have been to the TTTS Foundation website, https://www.tttsfoundation.org/  and they have some great additional information and support. Also, you may want to consider adding additional liquid protein to your diet - Boost drinks or other drinks with protein, the TTTS website recommends this, and many have had success slowing/reversing TTTS this way. Best of luck!

littlewonders

There are several reasons for growth discordances, TTTS being only one of them. Even though 15% discordance might not be much to worry about (although you're pretty early, so chances are it will only get bigger, even if it's not TTTS), I would just call and ask to see a doctor sooner. Preferrably this week. Seeing a peri or an MFM is an absolute must at this point, and if (s)he is not taking your concerns seriously, find another one. At the very least, (s)he should want to monitor you closely from here on out. When you're officially being watched for TTTS, you have u/s every couple of days (or 2x/week at least) because so much can change in such a short amount of time. We went from borderline TTTS (stage 1) to stage 3 (baby A experiencing heart compromise) in 48 hours. Did they say anything about your fluid levels? They would tell you more about a possible TTTS (and imminent danger to your babies) than a growth discordance alone.

 

I really don't mean to freak you out, it could very well be totally fine. But I've learned the hard way that many doctors are not knowledgeable enough about the dangers of TTTS and the reason it still kills so many unborn babies is that is usually gets diagnosed too late.