Nuchal Scan differences w/ Mono/Di Twins- early sign of TTTS?

GenieBK · January 2012

Hi! We had our nuchal scan today and learned that we are having identical twins! Very exciting news. But then came some scarey information.

So they measured the nuchal folds for each of our mono/di twins. Twin A measured 1.2 and Twin B measured 3.3 (OMG!). Hubs and I were scared and shocked at the difference. We didn't know what to think, is it possible for one twin to have a higher risk of downs? That didn't make sense to us since they were identical and made from the same stuff! We met with our doctor after to ask questions and see what she had to tell us about the situation. She said no, one twin couldn't have downs w/o the other having it.

But she said this difference in nuchal measurements can be an early sign of Twin to Twin Transfusion Syndrome (!!??? scarey) and I'm scheduled to go back for another scan in 2 weeks. I knew that mono/di twins are at risk for TTTS but this outcome of the nuchal scan is news to me. Wondering if anyone else out there had similar results or situations??

Any information would be greatly appreciated!! Emotionally drained from today.

pea-kay · January 2012

My coworker had the same thing happen to his twins. But they are fine. One was always smaller, and even their MFM said she'd be surprised if there wouldn't be something wrong with him. But nothing was. He's a perfectly healthy 9 month old now! (Both of the babies are.)

Hopefully everything will be okay with your duo as well.

Mrs. Alice · January 2012

Welcome and congrats on yout twins! I've never heard of this but with a google search this is what I found from the TTTS foundation site:

Does a high ?nuchal translucency? score mean my monochorionic twins will go on to have TTTS?There is not a clear answer here, but just plan for frequent ultrasounds to look for signs of TTTS, because all monochorionic twins are at-risk. Researchers have found that a discordance (difference) in NT of 20% or more is found in about 25% of monochorionic twins. In this group the risk of early fetal death or the development of severe TTTS is more than 30%. Conversely, if the discordance is less than 20%, the risk of complications is less than 10%. Obviously, the majority of these twins still do fine.

ninjabridemom · January 2012

My high-risk said it's one of MANY things they look for.

So it's not as simple as "yes, this IS an early indicator of TTTS." It *can* be. My guess is your OB will be more diligent about watching for other, more diagnostic TTTS indicators -- size and fluid level.

Ask to get a cord screen -- where they see how many vessels are in each cord. Which is another "this *can* be an indicator" thing.

erinruns · January 2012

Yes. This was exactly the thing that got us on the track for frequent monitoring. One baby was at 1.0, the other at 2.5mm. Because they're identical they doubted one would have Downs and the other wouldn't, so they looked for other factors.

Definitely make sure you are being seen frequently. I had my level 2 u/s at 19 weeks and that was when we realized that there was a decent size difference and their fluid levels were very different. I wish I had pushed for more u/s between the NT scan and the level 2 at 19 weeks. From 19 weeks on I had u/s minimally twice a week.

In the end, I had a lot of monitoring and my girls were born at 32 weeks. They are now happy, healthy almost 4 year olds with zero health issues.

GenieBK · January 2012

How many u/s did you have weeks 12-19? I will be going to the hospital every two weeks and my OB every 2 weeks, so basically going to a doctor each week. But the u/s machine at my doctors isn't the best so I'm not sure how clear of a picture I can get there and my OB is the one who usually does the ultrasound (who does not specialize in twins), not a technician.

Do you think every 2 weeks from now on is enough? Thanks so much! All the successful outcomes make me feel so much better!

ninjabridemom · January 2012

GenieBK:
How many u/s did you have weeks 12-19? I will be going to the hospital every two weeks and my OB every 2 weeks, so basically going to a doctor each week. But the u/s machine at my doctors isn't the best so I'm not sure how clear of a picture I can get there and my OB is the one who usually does the ultrasound (who does not specialize in twins), not a technician.
Do you think every 2 weeks from now on is enough? Thanks so much! All the successful outcomes make me feel so much better!

You need a better machine for sure. What about an MFM?

Also I was told every 2 weeks, and have been going every 2 weeks since 12 weeks.

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Nuchal Scan differences w/ Mono/Di Twins- early sign of TTTS?

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