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Treatment and Care Concerns

ashleymarie123ashleymarie123
in Multiples

I found out I was having twins via U/S ~10 weeks along.

My doctor has not once told me to do ANYTHING differently with this pregnancy vs a singleton. The only thing they have done differently is added an U/S at every appt to check for fetal heart tones b/c doc can't distinguish w/ dopplar. So far my appointments have been 4 weeks apart and they have scheduled my next one for 24 weeks. 

It's not evident whether the placenta is shared or not because it's always appeared 'together'. I ask at every U/S if they can see any distinction between placentas since the twins are dichorionic and they never could tell.

My concern is (of course) development of TTTS, ESPECIALLY since they haven't been monitoring growth. I have read that if it's not apparent whether there is a shared placenta, it should be treated AS a shared placenta. We did the full scan U/S at last appt (~20 weeks) and the twins were within 2 days, but 2 oz different and heartrates were 20 beats apart and they didn't measure amniotic fluid (don't know if it's very possible with twins).

I am on Medicaid so I had to start out at an OB/GYN but I'm fairly confident that Medicaid covers a specialist if you can get a reference and they have a perinatologist within my same group that I go to. 

So should I just ask for a reference and/or to switch doctors or am I just worrying too much? 

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Re: Treatment and Care Concerns

  • Temp6313048411121614Temp6313048411121614 member
    Most of the girls on this board feel that you should be seen by a specialist even if you do feel that you have good care.  In your situation I would definitely ask for a referral. 
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  • browneyedgrl4282browneyedgrl4282 member
    Everyone i know (including myself) who was pregnant with twins also saw MFM. I would ask and if the ob does not seem to want to sent you, I would find out about going else where.
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  • mbjmaybebabymbjmaybebaby
    Go see a peri (also known as MFM)
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  • wonder-kittywonder-kitty

    Insist, Insist, Insist!!! On seeing a specialist. My OB did not want to send me to an MFM, she siad it was not necessary even though we knew they were ID and shared a placenta. She blew this off as a normal pregnancy.

    Her casual attitude did not sit well with me and I called her office to insist on seeing an MFM and they did agree without any problems. Saw the MFM at 18 weeks and we were diagnosed stage 1 TTTS. I was not scheduled for an u/s with my regular OB till 21 weeks, and had I waited it may have been too late for my girls as baby b had very little fluid left.

    If you don't feel you're getting adequate care, then push to see someone who will take you seriously. 

    I have learned through this whole process that there are many OBs who are ignorant on the risks of multiples and you really have to advocate for yourself and your babies. Good luck!!

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  • Temp159135562506975Temp159135562506975 member

    get Dr. Luke's book on being pg with twins, triplets and quads - it will go over everything you need to know about WHY your pg is NOT the same as a singleton..... you can use it to argue with your OB if needed, about seeing an MFM/peri also.

     

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  • shellshavintwinsshellshavintwins
    I agree with every one on here, my girls placentas fused and it caused my baby b to have IUGR. If my ultrasounds had been read by the MFM where my non stress tests were done we would have known that my high blood pressure was effecting her. Thankfully she was born low birth weight for full term but very healthy.
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  • caitdanacaitdana member

    I am in the TTTS scare boat with you as well. My DH and I have 3 sets of fraternal siblings so my mom, mother in law, and step mother in law have all had twins. They never had to deal with TTTS and to be honest it probably wasnt commonly known 25-30 years ago.  So many people havent heard or know anything about it.  My step MIL is a nurse and it wasnt until she started to ask her Dr Friends and did some research did she realize how serious it could be. First off, you need to try to find out what kind of placenta set up you have going on. You have to have the Mono/Di to get TTTS. Are the babies the same sex? There is a website the TTTS foundation. There is a list of questions to take to your next  u/s appt. Even though they didnt tell me what all the answers as they were doing it, when I asked the questions they answered them. They should have measured the amniotic fluid at the growth scan. I currently go every 2 weeks and have an u/s meet with my peri/mfm and then go downstairs and meet with my ob/gyn.  I have been doing this since I was 16 weeks and depending on how things go wednesday, it may be on a weekly basis. These are your babies and you have to do what is right, so if you are scared then call the dr or nurse and just have them calm your fears instead of worrying all weekend. Just because there is a size difference doesnt mean you have TTTS, I hated hearing that, but it is true. It can be a clue to watch it more closely but it isnt the finaly decision maker. good luck and please message me, becaues like I said I am a scared sitting duck and I know how it feels!

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