Elevated cord flow

staceymack

Hi ladies,

My twins are being monitored by MFM twice a week for TTTS. Everything has been stable and not progressing so far. Today we were told that Baby B, donor, has elevated cord dopplers. The diastolic waveform is elevated. We are being rechecked on Monday. Depending on what they see then we may have to go to a treatment hospital. Anyone been told this and the dopplers be fine at the next appt? The fluid levels are stable at this time which is great. Of course, all that can change depending on B's cord flow. Thanks

Mrs. Alice

Wish I could tell you yes, but in our case the donor started having absent end diastolic flow but was able to last for 4 weeks like that.  I had to be admitted at 24 weeks for monitoring.  How's is growth? Good luck and let me know if you have any questions.

staceymack

Growth is good. Last Friday she was only two days behind my due
date and only three ounces behind her sister. How often did they check you after finding the elevation? I'm worried about going all weekend not knowing what's going on in there.

Mrs. Alice

staceymack:

Growth is good. Last Friday she was only two days behind my due date and only three ounces behind her sister. How often did they check you after finding the elevation? I'm worried about going all weekend not knowing what's going on in there.

I was diagnosed with stage I TTTS at 22 weeks.  They had me come once a week and at my 24 weeks visit my MFM found donor baby measuring 2 weeks behind with the bad cord flow.  They admitted me right then for steroids and I received fetal heart monitoring 2-3 times a day and an u/s 3 times a week with my MFM. Glad to hear your little one is still growing well! 

I was also due 9/29.  Sorry you are going through this.  It was really confusing and scary when it was happening to me and the Dr. we were seeing was not good at explaining things clearly to us. We ended up primarily seeing a different MFM within the practice who was much better.

staceymack

Thank you for sharing your story. They have never told me a stage, but have had me come in twice a week for the past 3 weeks or so. The fluid levels have been stable and both a growing. Yesterday was the first incident in finding something wrong with the cord. I go back Monday morning for another look. He said it could be back to normal or not. If not, he wants me to see MFM at the nearest treatment center. He keeps bringing up the ablation procedure, but he is not the MFM at the treatment facility. 

Once you were hospitalized did they give you the option to be monitored versus intervention? I'll be 23 weeks tomorrow and I do not want to do the ablation unless absolutely medically necessary. 

Mrs. Alice

staceymack:

Thank you for sharing your story. They have never told me a stage, but have had me come in twice a week for the past 3 weeks or so. The fluid levels have been stable and both a growing. Yesterday was the first incident in finding something wrong with the cord. I go back Monday morning for another look. He said it could be back to normal or not. If not, he wants me to see MFM at the nearest treatment center. He keeps bringing up the ablation procedure, but he is not the MFM at the treatment facility. 

Once you were hospitalized did they give you the option to be monitored versus intervention? I'll be 23 weeks tomorrow and I do not want to do the ablation unless absolutely medically necessary. 

Laser ablation for TTTS was not really an option for us since the fluid levels improved on their own once I went on modified bed rest.  My MFM consulted with one of the specialists who do it but they did not feel like we were candidates, so we never saw them.  Once the fluid levels stabilized my Docs weren't entirely sure if it was TTTS, selective IUGR, or both.  However absent and reversed flow is very common in TTTS pregnancies and they had such a difference in fluid levels, so who knows for sure.

staceymack

Thank you so much for your insight. We will see what tomorrow holds for us! Hoping and praying!