Question for other MoMs

Rannndi · February 2014

So we are 12.5 weeks pregnant with identical twins. Initially we were told that we'd have an ultrasound at each appointment (every 4 weeks until 16 weeks), and then we'd have more regular appointments with ultrasounds. We were told that at 8 weeks. Yesterday, my OB seemed EXTREMELY disconnected and treated us like we were no different than any other pregnancy. He said that our ultrasound looked good so we didn't need another one until 20 weeks. However, I know how quickly things can change with multiples and their growth needs to be monitored continuously. He then continued to say he'd see me like a normal pregnancy until about 28 weeks.

This isn't what I've heard/read about any multiples pregnancy. Does this sound right to any of you? Is this how your doc did things? It just made me extremely apprehensive after being told different things by them.

TREDgirl · February 2014

Nope. Question him and possibly go with another dr. Especially with them being identical there are a lot more risk factors involved.

I had a fairly complications free pregnancy with di/di twins and I was seen at least every 3 weeks with either my OB or the specialist. And I got an ultrasound each time.

Rannndi · February 2014

@TREDgirl - Thank you! I just didn't know if I was overreacting or if I had validity for my concerns! I'm definitely going to call and question it more.

MrsP419 · February 2014

You are definitely not overreacting. I switched from a practice I loved around 12 weeks because I felt like they weren't really equipped/of the mindset for a high risk pregnancy. I see both my OB and maternal fetal medicine specialist every 2 weeks, and I am considered "lower" risk with di-di twins. Have you been referred to an MFM yet? With identical twins (do you mean one placenta?) I would think that would be necessary.

jezebel57 · February 2014

With identicals you need to first find out if they are mono/mono or mono/di. They are both high risk but mono/mono is more so. You should make an appointment with a MFM as soon as possible. They will see you every 2 weeks starting at 16 weeks for fluid checks and growth scans to keep an eye out for twin to twin transfusion. I just delivered my mono/di boys a month ago at 36 weeks with a planned c section. Feel free to PM me! Good luck and congratulations!

Rannndi · February 2014

@MrsP419, yes one placenta. @jezebel57, they confirmed yesterday that they look to be mono/di. They hadn't even mentioned an MFM, but I'll definitely be contacting one on Monday. Thank you guys for your advice! I know I have to do what my gut is telling me, and things just weren't feeling right. You've been a big help!

whitehousem · February 2014

I have mo/ di as well and am 25 weeks tmrw. My OB referred me to a MFM immediately (basically pushed me out the door when they saw it was prob identical twins). I saw my MFM at 11 weeks, OB at 12, MFM at 16, 18, 20, 22, 24... Will go at 26, 28, then OB at 30...MFM at 32, then one or the other every week. I get an ultrasound every time and they are way more high tech at MFM than OB. They check for TTTS (fluids, bladder, etc.) every time and growth scan every other time (so every four weeks). Def get a referral to see a MFM, so you can be monitored closely. Best of luck!

ETA: according to my MFM, TTTS is more severe the earlier it starts. At 20 weeks it is much less likely that it will appear at all, so it doesn't make sense to NOT have ultrasounds between now and 20 weeks to monitor for that.

LittleLady77 · February 2014

AnotherDreamer said:

My understanding is that sharing a placenta and/or sac puts it at higher risk than if they were di/di. We have di/di and my OB sees me every 4 weeks, however I also see my MFM every 4 weeks as well (so basically I'm seeing someone every 2 weeks right now). Later on I will be seeing them more frequently too, earlier than when they begin extra monitoring in a singleton pregnancy. Personally I think you should definitely push for a MFM referral, and if your OB doesn't want to do that I would consider another OB altogether.

This is us exactly. I would either be upfront with your doc about your concerns and get the referral to a MFM and/or find someone else.

carrotcake06 · February 2014

Same as @anotherdreamer and @littlelady77. My boys were di/di. I didn't have any u/s between 12 and 19w but that would have been different had they been mo/di. I also didn't have u/s at my OB, just the MFM.

Ylvelill · February 2014

Also consider the hospital you will be delivering at. Does it have a good nicu? I had to switch ob to get one that would deliver at our lvl 3 nicu

LegalLadyBug · February 2014

Mine are di/di but my OB considers all twins high risk so I have ultrasounds every 4 weeks and then every 2 weeks after 28 weeks. I would definitely question your OB on that. It's not too late to make a switch to another OB either if you aren't comfortable with or confident in this one.

xnbride · February 2014

Have you been referred to a MFM? I see both my midwife/OB and a MFM. They co-manage my care. Basically the OB is your doctor and the MFM is your babies doctor.

Jamie718 · February 2014

My twins are di/di and my OB does an ultrasound at every appointment, which will now be twice a month since I'm 27 weeks. I also see the MFM once a month for growth scans.

I didn't like my first dr and am so glad I switched. I don't need to be buddy-buddy with my OB but I need to trust him and feel good about the care I'm getting.

Stephanie2167 · February 2014

I agree with everyone. My girls were di/di. When I found out it was twins, I was at a different OB. I never saw a doctor, just a nurse until I moved to a different state. At my first appointment at the new OB, I was given an ultrasound (16 weeks) when they found out my old practice never did one when I started bleeding at 12 weeks. At that same appointment I was also referred to a MFM who I saw at 20 weeks and then every 4 weeks from then on. So I was at the doctor every 2 weeks. One at my OB and one at my MFM.

Since yours are suspected to be Mono/di, you for sure should be seeing a MFM.

Rannndi · February 2014

Thank you all so much! You've given me the confirmation I needed to push a bit harder! When the office calls me back Monday, I'll push for an MFM referral. If they're reluctant, I'll definitely be switching! The hospital that I'll deliver at is also another concern! They'll only be able to keep the babies there if born at 32 weeks or later. I understand that anything can happen, so I haven't been comfortable with that either!

SWA80 · February 2014

I switched at 18 weeks because even though the OB I was seeing did scans every 2 weeks, they weren't checking fluid levels. I just didn't feel comfortable with the level of care so I switched to an MFM that delivers.

legaleagles · February 2014

AnotherDreamer said:

My understanding is that sharing a placenta and/or sac puts it at higher risk than if they were di/di. We have di/di and my OB sees me every 4 weeks, however I also see my MFM every 4 weeks as well (so basically I'm seeing someone every 2 weeks right now). Later on I will be seeing them more frequently too, earlier than when they begin extra monitoring in a singleton pregnancy. Personally I think you should definitely push for a MFM referral, and if your OB doesn't want to do that I would consider another OB altogether.

This is what I'm doing, see MFM and OB each every 4 weeks, but alternating schedule so I'm seen and have an US every 2 weeks (OB does them to check position and heart beats) MFM does the growth scans. I'm di/di and relatively low risk (I've had some shortening and contractions, but still looking good) and this was the plan before any of that started.

I'd definitely push for more appointments and to be referred to an MFM.

KatieGummow · February 2014

I am with di/di boys and my OB does an us for heartbeats and movement only. I also started seeing my MFM once a month after 12 weeks. My OB does a cervical check at every appointment and is the only one who will see me (she doesn't let the nurse practitioner see me). Even though I have a "great" cervix and an uneventful pregnancy, as well as di/di which is the lowest high risk twin pregnancy, my OB takes it very seriously. I would switch to someone who will take better care of the three of you, especially because your babies are mono/d or mono/mono. I'm sorry to hear you have to go through that.

SandraPB1220 · February 2014

I'm mo/di and I've only been seeing my OB every 4 weeks, ultrasound every 2 weeks since 18 weeks. My OB said I'll be seen more frequently after my next appt (25 weeks) and at 30 weeks I'll start weekly NST. I haven't been referred to MFM, and haven't been worried so far, but after reading all these, I'll definitely be asking the OB I see at my next appt (different than the one I saw Thursday) about the plan from here out.

Rannndi · February 2014

You guys are all so awesome! Thank you so much for the confirmation. I have my calls out already and will be transferring my care to an MFM that will deliver to the higher level NICU in our city. I'll feel much more comfortable when all is switched over. Thanks again

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