Our twin pregnancy adventure has gotten a little more nerve-wracking in the past 24 hours.
Yesterday I took my Dad to my usual ultrasound/perinatologist appointment to check on the twins. The ultrasound went great and my Dad loved being able to see the babies :) During our appointment with the perinatologist the doctor let us know that there is a difference in the amniotic fluid levels of the twins. This is usually the first sign that we may be dealing with TTTS (Twin to Twin Transfusion Syndrome). Although this is an early catch and there isn't anything that can be done at this point until more drastic differences present themselves, I asked the doctor to walk me through all the possible options so that we could be ready for whatever this journey has in store for us. Here are the possibilities:
1.) During the next ultrasound the doctor sees that the amniotic levels of both twins are in an acceptable range. If this is the case then we will go back to our regularly scheduled programming with ultrasounds/perinatologist appointments every 2 weeks until I am 32 weeks. At that point I will go in for ultrasounds, perinatologist appointments & 30 minutes of fetal/contraction monitoring every week. Once I get to 36 weeks, I will go in 2 times a week for all the same monitoring until the twins are born which will need to happen before 37w/6d to avoid additional risks.
2.) The ultrasound shows there is less than 2cm of amniotic fluid in Twin B's sac. This means we need to begin consulting with University of California, San Francisco Fetal Treatment Center. The will let the doctor know whether or not I need to be flown to San Francisco right away to have the TTTS procedure done. Here is a link to the website that breakdown TTTS, the procedure and recovery time (https://fetus.ucsf.edu/ttts). The cut off for having this procedure done is 24 weeks because after that point the twins are viable, or can survive outside the womb with the help of the NICU. I am 24 weeks next Friday so if I need to go to San Francisco it will be next week shortly after the doctors appointment.
3.) There is a larger difference between the two amniotic levels of the twins but it isn't drastic enough to require laser surgery. The doctor will still call up The Fetal Treatment Center in San Francisco to see what they suggest. There are some treatments that can be done by the Kaiser doctors at Sunnyside Hospital in Clackamas. One option is to reduce the amount of amniotic fluid in Twin B so that the twins have similar levels again. Although this doesn't always work long term to fix the problem it may help the issue long enough to keep the twins cooking for longer. Another option, since I am so close to the twins being viable, is to go inpatient at Clackamas. You may remember me talking about this back when we thought we were dealing with Mono-Mono twins. This is where you check into the hospital between 24-26 weeks and the begin monitoring the babies for 3 to 24 hours a day to check the twins' heartbeats, my contractions, and general twin development. As soon as one of the babies starts to show distress or their heartbeat drops below a certain point, you are prepped for c-section delivery while they try to get the twins to level out again. If within 2 minutes, things go back to normal then you go back to monitoring and keep those babies cooking for another day. If things don't improve, you are wheeled into the OR and they deliver the twins and get them into the NICU. Although all of the monitoring is stressful and can leave you being in the hospital for months before the babies are born, in some cases it is the only way to ensure the survival of both twins.
We scheduled the next ultrasound for Tuesday at which point we will find out where we go from here. We are going to do whatever is necessary to get both of these babies earth-side. The doctor said that there is absolutely nothing I can do between now and Tuesday that will help the situation so back to prayer and positive thoughts it is. I am so grateful that modern medicine has given us so many options and possibilities :)
Things are getting pretty tight around here. When I look down at my belly I can see where I am larger on one side than the other. Greg and I are pretty sure that my belly is larger now with the twins than it was when I was full term with Juniper. Pretty crazy to comprehend when you consider that I still have 3 months to go!
We successfully moved our bedroom down to the main level which is WONDERFUL! I have been able to drastically reduce the number of stairs I am climbing each day. The pain I was feeling in my lower back has all but gone away except when I am out grocery shopping. Huge improvement!
My Mom and I have been ordering decor for the twins' room and it has been a lot of fun! We've ordered the baby quilts, sheets, curtains & rug. We are going with a Neverland theme for the entire upstairs floor of our house since that will be where all the kids will be. Juniper's room is based on Tiger Lily's Indian Camp, her closet is Mermaid Lagoon and the twins' room is the Lost Boys Hideout. Things should start arriving in the mail early next week and it will be really nice to get their room all set up.
Every day is a blessing and an adventure. No matter what lies ahead, we are grateful for all the love and support we receive from our family and friends.
Never a dull (or normal) moment!
Love,
Whitney