Friday, March 06, 2009

Monozygotic Monochorionic-Monoamniotic Twin Girls!


Try to say that fast three times! With as much of a mouthful as it is, that is the type of twin girls we are having! Confirmed last Monday evening at the hospital with a high resonance ultrasound machine. This occurs in approximately 1 in 60,000 pregnancies! Still what does that mean? Here it is in a nutshell.... Monoamniotic twins are identical twins that develop inside the same amniotic sac. Also known as MoMo twins (Monoamniotic-Monochorionic), monoamniotic twins are always identical. These share a placenta within their mother’s uterus, but have two separate umbilical cords for nourishment.
All I can say is that it is comforting to know that God's plans are bigger than ours and He has everything under control because statistics definitely say otherwise. We are in one of the highest risk pregnancy categories now. Next only to Siamese twins. So, I thought I'd add a list of the possible complications and ask that everyone pray for us that this pregnancy lasts until at least 36 weeks and we are able to amaze doctors as we breeze through this all.
I was told from the beginning that the survival rate for twins of this type is only 50%. That's not enough in my book. So we really need prayer for this. Here is a list of reasons why this holds true:
  • Cord Entanglement: Cord entanglement is one of the main complications associated with monoamniotic twins. Because the twins have no amniotic membrane separating them, their umbilical cords can easily become entangled. This can hinder fetal movement and development. Additionally, if the twins become tied together in the uterus, one twin may become stuck in the birth canal during labor and delivery, which can be life threatening. Cord entanglement happens to some degree in almost all monoamniotic pregnancies.
  • Cord Compression: Cord compression is another life threatening condition common in monoamniotic twins. As the twins move around in the amniotic sac, it is possible that one will compress the other’s umbilical cord. This can prevent vital nutrients and blood from traveling to the other baby, resulting in fetal death.
  • Twin-to-Twin Transfusion Syndrome (TTTS): Twin-to-twin transfusion syndrome can occur in monoamniotic twins. This syndrome happens when one twin receives the majority of the nourishment in the womb, causing the other twin to become undernourished and sickly. Typically, TTTS is diagnosed by examining fluid levels in the two amniotic sacs. But because monoamniotic twins only have one amniotic sac, diagnosis of TTTS is much more difficult. Diagnosis rests on comparing the physical development of both of the twins.
  • Preterm Birth: All monoamniotic twins are born premature. This is because full-term pregnancy is deemed unsafe by most medical professionals. The risk for cord entanglement and compression simply becomes too great after 34 weeks. For this reason, all monoamniotic twins are delivered by cesarean section at 34 weeks. However, many monoamniotic twins experience life-threatening complications as early as 26 weeks, and need to be delivered immediately. Preterm delivery is often associated with a number of life-threatening conditions.

We have another appointment as soon as possible following our return to Idaho and my OB is referring us to a Perinatologist who specializes in high risk pregnancies. My God is bigger than all of this and as the fear sneaks in He helps me press it out again. At the last ultrasound the girls umbilical cords showed great blood flow and their measurements were almost exact! So far so good, everything looks great!

1 comment:

Lorelei said...

Amen!
Just reading that list of possibilities had me getting a little nervous, but truly, with God, we can do all things. I'm pretty sure that 'all' includes delivering MoMo twins that are healthy and normal. I'm praying for you guys and can't wait to see the little beauties!