Amniocentesis, 21 weeks with twins

[Bengals]

Hi,

I am look for some views and hopefully success stories from those who have undergone a amniocentesis with twins (fractal) at 21 weeks.

My story so far is -
DH and I had a success round of ICSI which resulted in this current pregnancy. I am 30 and DH is 41, both healthy with no family history of birth defects etc. At 13 weeks we had a successful NT scan - by that I mean that our right twin came back with a reading of 2.9mm on her fold which is boarder-line while the left twin her reading was well within normal limit. I underwent the blood test also and was then given the all clear.

Last Sunday I went for our anomaly scan where the right twin had a Posterior Ventricle reading of 10mm - again boarder-line and the upper limit of normal. We spoke to our OB who suggested if we werent happy to have a second scan from a different Dr (the Dr that did the first scan had a dreadful bedside manner and kept on pushing very strongly on my belly as he was having problems collecting the different readings).
Anyhow yesterday we had the second scan where everything was within normal readings for both twins, the only question mark was against the VP reading - it came back at 10.40mm for the right twin.

The Dr explained that it could be something or it could be nothing. He suggested that we preform some blood tests to check for viral infections and then book for a amniocentesis. We have booked it for this Sunday at 5pm but now I do not know if I want to go through with it. Does anyone have some success stories of having a amniocentesis or even had readings the same as mine?

Thanks in advance

I had bilateral ventricle readings of 16mm for one of my twins at 20 weeks which increased to 21mm at 26 weeks (so very severe), I had the Torch analysis, and mri, but refused an amino, my twins are now 6 months old and absolutely fine. With mild ventriculomegaly (between 10 and 12mm) I think the chances are about 97% that things will be fine. I found the consultants to be very pessimistic about my babies chances of a normal life, but looking back on it I guess they have to prepare you for worst case senerio.

I'm afraid I can offer no help or advice (I had a nuchal reading of 2.9mm at my 12 week scan and currently awaiting the 20 week anomoly test- hence I read these type of threads just to worry myself more!).

If I were in your situation I would want to know exactly:

• What would be the implications on the baby if there was a problem. Are there degrees of problems for the baby- i.e. some very mild (I would probably want statistics- but then I am a control freak and like to be fully informed of everything!)
• How I would cope with these varying degrees of issues (if the worst case scenario happened). At 10mm reading what are the chances of a problem (as you say it's so borderline) twotimes* has suggested this is 97% chance all would be fine.
• What the risk of miscarriage is at this stage of your pregnancy if you had an amniocentisis.

Personally- unless the risk was very high and the implications on the baby were so severe (I'm talking serious impairement rather than mild disabilities) I would not risk the amnio as I could not put my baby at risk. I was actually chatting to a screening midwife at the hospital yesterday who said it's only a 1% risk of miscarriage but someone has to be the 1% and she said they are always the nice normal people, and the babies are normally perfectly healthy.

I'm probably not helping much- I guess I'm saying I'd ask myself lots of questions, and find out lots of statistics and based on the risks I would then decide on the amnio. If your risk is only 3% there's a problem I'd probably have the bloods but ride the rest of it out...

Best of luck with whatever you decide to do- I sincerely hope everything is fine, and at the minute it sounds the odds are well stacked in your favour xxx

Hi - this is so so difficult.

I had an amnio at 29 weeks for my twin 2. All was fine - but I think that nearlymumofone gives some really good advice of things to think about. It was a horribly difficult decision. Mine was for a different reason - so I have no view on your readings.

The Dr was really pessimistic on the chances of twin 2 being healthy - in retrospective - I think uneccesarily so.

If you do decide to go for an amnio - then go somewhere where you will get someone who has done 100s of the procedures (eg the Fetal Medical Centre in London). I believe that the stats fall below 1% if the procedure is done by a more experienced practitioner.

You can choose to go the FMC just for this procedure - and they can also give you a second opinion on the readings. You can refer yourself.

Good luck,

Twins now asleep so can write a bit more. I also went to the FMC for additional scans, they were brilliant and very experienced in doing amnio's on twins. If we had made the decision to have one, they are who I'd have trusted to do it. For me it wouldn't change outcome, and although I wanted to know as much as possible hence the torch and mri, but avoided invasive tests.

Best of luck whatever you decide, i'll be thinking of you.

I have been through the same thing at the 20week scan although not with twins, just a singleton. My daughter had a reading of 10mm on her right ventricle (BTW, you are referring to ventricles in the brain, not the heart? Sorry for my ignorance, just wanted to check I was talking about the same thing as you).

Anyway, I was distraught as I was told the main complication may be spina bifida and/or hydrocephalus (water on the brain).

We waited 2 weeks for a repeat scan and this time the measurement was reduced. No explanation, just that the readings taken by sonographers can be slightly out or the scanners can be oversensitive.

In your case, as you've had two separate scans and both were the same, it does appear that the reading is accurate. Have they suggested that you wait 2 weeks and have a repeat scan rather than having the amnio?

The other thing to mention is that you are still at the edges of what is considered 'normal'. As twotimestwo says, with a reading like this, the chances of anything being wrong are highly unlikely.

Just found this thread on another forum where a poster gives a lot of info about ventriculomegaly. You may find it helpful.

community.babycentre.co.uk/post/a6908125/enlarged_posterior_ventricles_at_20_week_scan

Hi there, I have identical twin boys now 3 years old. At about 20 weeks both twins had enlarged ventricles ranging between 11-14 mm. We were sent to FMC for lots of detailed scans, torch screening and an mri. They too were quite pessimistic about outcome of pregnancy and wanted to do amnio. I refused this as torch screen came back ok and mri showed brain was normal, throughout rest of pregnancy scans showed the ventricles were still enlarged but no worse. After the boys were born they scanned and then again at 6 weeks, the ventricles were measuring within normal range. It was all very stressful at the time but I am glad I did not have the amnio and risk mc or babies being born very prematurely. At 3 years the boys are happy, healthy and great fun!

Thank you all for your comments and best wishes. My DH and I decided to cancel the amnio which would have been today today. The risk factor is just to high for both babies - my OB called me as I emailed her directed and she said offline that if she was me with the readings etc she wouldnt have the test due to the fact that if I do miscarry the chances are it would be both babies. We will love these babies no matter what.
Thank you all again - very inspiring :)

bengals for what it's worth I think you have totally made the right decision. I would have done the same in your position.

Best of luck. Remember your odds are very very good and there are lots of similar positive stories on here.

Take care xxx

Good luck from me as well, easier said than done, but try not to worry too much and enjoy the pregnancy. Twins are wonderful, the first months of sleep deprivation are hard and even worse if you're looking at one of your babies and worrying that there is something wrong, but it gets so much easier, and having two is brilliant.