Worried about my twin pregnancy...

[dreamfeeder]

Hi all,

I have also posted on the twin club antenatal thread, but wondered if people here could help me too...
I am 13 weeks pg with (probably) DCDA twins. I have a 13 month old DD. I am really worried about something going wrong in the pregnancy or delivery of the babies, and waould like some other people's experiences.

This is nothelped as the hospital trust we have to use has a Red Alert for poor maternity services. They HAVE to make improvements by next year, but that doesn't help me now!!! One example is they can't offer any antenatal screening, like Nuchal Fold Scanning, and as a blood test for DCDA is no use alone, I can't check out any Downs risk, which I know is higher with twins.

I would like to know what number of scans people have had and when, and when the heartbeats were first listened to. I am not having a mw appointment for this at 16 weeks as she said you can't do it with twins as you can't tell them apart then so no point. I'm very disappointed, as I'd just love to know both are still doing ok. As I also can't have a nuchal fold scan, there's nothing til 20 weeks.

I am a worrier, but I just want to check this matches other people's experiences?!

I will worry about 3 children under 18 or 19 months closer to the time!!!!!

Hi, congratulations on your dts.

I have b/g twins (and dd1 was 17 months when they were born) and think I worried throughout the pregnancy as I was worrying about two babies so it was twice the worry!

My dts were dcda as well and as they have their own sacs and placentas it was classed as a lower risk pregnancy. There was no risk of twin to twin transfusion so I needed less monitoring. (this was what I was told but you might want to double check with your dr/mw).

I'd be annoyed if my mw didn't give me an appt just because she wouldnt hear the heartbeat though, if you have concerns and worries I'd make an app and discuss them anyway.

I had two scans at 12 wks as the first one couldn't tell what type of twins they were so was sent to the consultant (he was not impressed with the original radiographer), but then I didn't have another one until 20wks.
There is another thread on here saying the nice guidelines for scans in a multiple pregnancy so might be worth a look at that?

Don't think I had many mw appts until around 20 wks either, but that was the same with my singleton pregnancy as well.
I do remember my mw struggled to find heartbeats at the first appt as dts weren't in helpful positions but I felt them move a lot which was reassuring.
The movements were felt a bit earlier and a lot stronger than dd1 as I guess there's less room so they were easier to feel?

Are you in a position to pay for a nuchal fold scan privately? Might be worth it for your peace of mind?

Hope everything goes well for you and your mw can help ease some of your concerns.

Hi! When I was pregnant with my twins I only had a couple of extra scans, to ensure they were both growing and not T.T.T. I had normal MW appointments, just a couple of extra at the hospital with the consultant.
Heartbeats could prove difficult to find but you will really notice the movements as they get bigger and find you may even be able to tell which is moving at any one time. On one scan I even saw T1 kick T2 in the head, they haven't changed . They did nuchal scan but not blood test as it is said it does not work for a multiple pregnancy. I'm sure you will be fine but stay on the boards and always post if you have a wobble. My twins were only just over a year old when I fell for my 4th DC, three under 2 is possible and no-where near as bad as I feared. Mine are now 11, 6, 6, and 4 and I would not have it any other way, my neighbours may say differently .

Thank you for your reassurance!

I have checked the NICE guidelines now acceptableintheeighties, and for DCDA it's scans monthly after 20 weeks- so recommends 24,28,32 and 36, and every fortnight for MCDA/MCMA I think even from earlier (I didnt pay so much attention as I think that's not me!). It does talk about councelling on increased Downs risk etc, but I will ignore that.

I could possibly pay for a private scan, but I'm 13 + 2 tomorrow, and there is nowhere local- I live north of Lancaster and would have to go to Leeds or Manchester, and have no idea where or how, the midwife just mentioned this. Not sure about the practicalities of getting myself and DD there etc and arranging it for monday or tuesday before I'm at work and then I'll be past the 13+6 cut-off for the scan...

I don't get any midwife appointments now- she said I won't see her again... Unless I'm asked to go by the consultant in later pregnancy. It seems I get less appointments with DT's in this area, not more!!! There is a midwife drop-in clinic, so maybe I will risk trying to persuade one (and hope it's not mine who told me not to) and see if they'll have a go at heartbeats for me in a few weeks!

I am really, really excited about twins now, and have already convinced myself it's the best possible outcome for me (I always wanted at least 3 children, while DH only really wanted 2, so I was expecting a battle for number 3!) and I will cross everything I have a totally normal pregnancy and 2 lovely babies at the end.

I'm shocked that you won't be seeing your mw at all?
Unless you will totally be under consultant led care?

I still saw my mw for blood pressure checks etc but saw the consultant after the scans after 24 wks.

Dts are fab and my three dc get on so well being so close in age, you will love it, there are tough moments but it's all worth it!

Oh and my dp only wanted two too!
He should know by now I always get my way!

lol acceptable, we got them there with the twins!! (well, fingers crossed I do!).

When the midwife left last Wednesday she specifically said she wouldn't/didn't need to see me again, unless the consultant said to towards the end of the pregnancy. She definitely won't see me at 16 weeks as she says there's no point as she wouldn't listen for the heartbeats, so that seems to be that... I assume that means I'll be totally consultant led, but it's not blindingly obvious what's going on to me!! Dodgy trust and all, who knows!!!

I saw a mw at 17w then it was consultants every fortnight (mcda twins). I'm a huge worrier but 6 weeks ago I had my dtds by cs. It was a lovely experience and they are fab. 8 days in SCBU but they were never in any real danger just needed help gaining weight.

Congratulations, just take it easy. By the end I was really struggling with exhaustion caring for dd1 so my parents had to step in for me and help. It was a huge relief to get the girls out tbh! ;-)

Oh congratulations princessScrumpy, well done you! I hope life is settling down and you're enjoying (the good bits!) of the girls being here and you've recovered well from the cs. How was that? Did you have to have one as the girls were MCDA or did you elect to have it?

I'm already more tired this pregnancy, whether through chasing a 13 month old round all day or the twin pregnancy itself... Today my dad and his wife have had her most of the day. I am sat on the sofa with a brew in peace!!! Unfortunately my dad says don't get used to it, but I'm sure he would help towards the end (fingers crossed)

both dtds were breech and I was told vb was not safe. tbh dd1's vb birth was horrific so I found I've recovered better from cs and enjoyed the early days more.

I felt fab around 20w to 32w, then I got too big (imo). From behind I didn't look pg, but when I turned round, well that was another matter!

Congratulations Dreamfeeder I have 11 month old id twin girls. I had fortnightly scans from 16 weeks and gave birth by emergency C section at 34&3, girls were healthy and happy I found the whole pregnancy horrendous if I'm honest but it all turned out well!

I would give Tamba a call the NICE guidelines for multiple pregnancies are very new, and it's well known that different hospitals do better jobs than others, they should be able to support you in getting the correct care.

Good luck with your pregnancy!

Thanks!

princessScrumpy, I found DD's birth fairly horrific, with a third degree tear, big bleed and anaemia afterwards, I struggled a lot after the birth. I walked up a hill by myself after my waters broke to try and get things going (didn't work, so I ended up induced for prolonged rupture of membranes) and felt pretty fit up to going into hospital. After the birth, I was feeling faint and dizzy walking up stairs after the bleed and tear repair surgery, and traumatised by induction and whole experience. Is it bad that I'm secretly hoping for them to be breech so I don't have a choice and a section is the right thing to do?!? Anything but induction again...!

Thats sounds like good advice LaVitaBellisima and thanks. I know the guidelines are new, and that my trust is pretty hopeless, hence it's red alert status for maternity care. So long as the basics are there I'm not too worried. I do know the consultant I have requested to be under is very good. I am still a bit miffed I couldn't have any ante-natal screening, and don't know what will go on appointment-wise as the midwife has said that's it from her without telling me what to expect instead, but those are minor points really. I'd never thought of ringing Tamba. Do I need to join first? I haven't done anything like that, in case I jinx this pregnancy and something goes wrong (I hope you like my rational and logical thinking!!!).

my DH is fed up of me worrying, and made me go and look at MPV's so we could get an idea of what might be suitable for 3 whacking rear facing seats/ DD's Besafe and 2 babyseats. THAT better not have jinxed me!!!! . And is another kettle of fish I'm dreading getting into...

No Tamba are a charity and are there to help, also the MBF (Multiple Birth Foundation) are fab as well. I completely understand all the jinxing/fears worries, I think all- most pregnant women have them regardless of it being a multiple pregnancy, but it's best to have as much information as possible.

Hi dreamfeeder, i have been watching this thread until i had time to sit down and reply!
Congratulations on the twins, i have 4mth old dcda twin boys. There is a LOT of controversy regarding my local health authority atm, national news, i wonder if we could be in a similar area?
I had a very quick natural birth with a little g&a, i was determined to not be told cs or induction just as amatter of course, of course if they had been necessary i would have.
I had complete consultant led care, i only saw my mw at booking in, then never saw her again. I had a scan every three weeks, then consultant straight after, about a two hour apt every three weeks! But i also had obstetric cholestasis, (which i had with ds1, but not as bad) so my appointments got to every two weeks, then every week for about 4/5 weeks before i gave birth.
My waters broke at 36 weeks and both babies were here within 3 hours! I was an hour away from hospital when waters broke so it was a rush!
Tamba is excellent for information, and i was also advised to get a copy of your local hospitals twin birth protocol for peace of mind. I never got round to that though.
I have also just bought a VW Touran to fit 2 rf car seats and one ff, its fantastic, my adbice would be to get bases for your rf seats, you dont have to strap the seat in every time then and they are singularly the best thing i bought out of everything!
Congratulations again... Wow sorry that was long! :)

Just wading in to add my experience. My dcda boys are now 6 months old. I had a couple of early scans as I was having treatment for recurrent miscarriage. Hospital scheduled me for scans at 12, 20, 24 and 28 weeks (I think). Am v shocked at your midwife. My midwife said to come when I wanted but they understood that I may not want to as the pregnancy progressed and I spent more time at the hospital (especially as I was working full time). I took them up on checks early on as it was good to double check bp and get the urine test. They also did listen in but couldn't promise they could hear 2 separate heartbeats. I found it reassuring but went for a private scan at16 weeks as I was so worried about miscarriage. At the 12 week scan I refused the results of the nuchal test as we had already decided not to do anything whatever the results.

At about 28 weeks the readings for Twin 2 were a bit on the small side so I then had twice weekly (reducing to weekly) heartrate monitoring, fortnightly scans alternating with fortnightly doppler scans.

The boys were born at 40+2 vd (ventouse). Twin 2 was 5lb4 in the end and needed a couple of days in SCBU. All ok now.

I would say its worth asking the same questions again as I had diffeent messages during my care.

Wishing you the best of luck with your pregnancy - I hope you get what you need.

Just to add, i could have seen the mw if i had wanted, but i felt i didnt need to. Especially as my consultant appointments were so regular

byeckers, are you University of Morecambe Bay Hospital Trust by any chance?! I will take your advice on car seats. A neighbour has a Touran, she's lovely, I might ask for a quick go at putting car seats in and a poke around! Your birth sounds great! I'm scared about it already... I had a rubbish experience with DD and it's just made me doubt whether I can do it with 2. I will wait til I've seen the consultant and had her advice. And I'd love a scan every 3 weeks - the obstetric cholestasis sounds grim though, not if I have to have that!!

DW123, Thanks for the scan info and advice. maybe I will try and go to a mw drop-in session. I feel like an idiot now mine told me not to though. I wish DH would agree to a private scan but he says paranoia is not an indication!!! I'm glad to hear they do monitor you really well (hopefully) if there are any concerns. Bit horrified at 40+2 though!!!

Dreamfeeder, yes :o

The care i got was excellent, both before and after, the news whilst awful is not a true representation of the whole trust. Especially not lancaster imo

Yes, its definitely Furness general that's the bigger issue. Interestingly on going back into work for the first time today (I'm NHS) I did see an email about the maternity services (which I read above the 500 I deleted!)- it doesn't look great for Furness which has more issues, but lancaster is not exactly home dry either. Was talking about Monitor who have stepped in to try and up the game, but improvements just aren't happening fast apparently. My midwife was saying about the lower standards of care with the lack of staffing and training- for example, she was talking about having no sonographers trained to do the nuchal fold scan in the trust, at all, etc etc. She said care her daughter had with her firstborn who's nearly 2 just isn't available here yet, STILL. i'm Lancaster too btw.

I'm encouraged by your care though, I hope this means I'll have regular consultant appointments at least if I'm not seeing the midwife. Probably good, my mw's a bit scary!!!

I agree my family has suffered first hand with another ward at lancaster, that has a bad reputation.

I did have one issue on the antenatal ward after my boys were born, but it was more an uncaring midwife, long story that would probably out me in rl, but nothing major and i just stood up and said i wasnt having it. Another midwife admitted to me they had been instructed to do everything to the letter due to this very investigation just starting to come to light (june) no common sense was applied by her, but every single other midwife was amazing.

I did wonder why i wasnt offered that scan, although with the twins the blood test for ds is not given due to skewed results.

Please feel free to message me if you want to know anything, good luck with your pregnancy. :)

Oh thanks byeckers that's great. You can do the nuchal fold scan and blood test for twins, but need to adjust it using a formula for each twins risk's plus the results of the NF scan. It will be available in Lancaster at some point in 2012 my mw said- or at least it's meant to be after this investigation. The trust will have to invest and train some sonographers etc.

My booking in is STILL not complete, I have to go back for bloods for the third time for a ?lost ?too late to lab sample. Nightmare as my mw is a butcher for getting blood, 8 days on both arms are still bruised from where she tried last time!!!

Hi there, just wanted to give you some info about private nuchal scans if its not too late. I didn't have one with my twins (they're now 6) - in fact I didn't have any checks until the 20 weeks scan and was a nervous wreck by then so I understand completely that its a worrying time. I live in Manchester but work in Leeds and I went to a private clinic in Leeds with my 2nd pregnancy for the nuchal fold scan (you'd need to get the train to Leeds and then its a 5-10 minute taxi ride as its not walkable from the station). They were brilliant though and it was well worth doing in my opinion (my risks went from 1 in 220 to 1 in 35,000).

I had lots of scans because I had an early bleed and also because my dating scan was incredibly early (8.5 weeks - in my area, it can be anytime between 8-12 weeks) - I pestered for one after the 12 weeks but before the 20 weeks and got one about 13 weeks from memory.

If its any reassurance, I got excellent care - I think you have to be forthright in any appointments you get to say what you want in terms of m/w or dr appointments / scans but in terms of the actual birth, I'm sure you'll be very well looked after. I think most maternity units (sweeping statement) will give you more care, even if you're not deemed priority / high risk, simply because its a twin pregnancy.

Good luck

Thanks mandy that's great! Unfortunately, I only found out it was twins at my dating scan at dead on 12 weeks, saw the mw at 13 (because she ended up cancelling the first appt as she had to attend a home birth), and she told me I had to go to Leeds privately and go before I was 13+6. As I was 13 then, that gave me the weekend, plus 2 days (as I worked the next 2) so it didn't happen in time. Now I'm having loads of sudden, sharp pains and cramps and am having a panic something's up... I even googled our local private scanning clinic but due to staff illness they're not operating at the minute, so I can't even pay locally!

I have a consultant appt next Thursday, so I will be mentioning these cramps, playing it up as much as necessary until I get some reassurance- hopefully by the consultant whipping out a scanner. Or is that too much to hope for?

Our trust is on the news again- worst trust in the country for hospital deaths!!! Plus it's red alert maternity services. I will certainly ask for what I think is needed, from the marvellous info on here!

I will ask DH about going to Leeds for a private scan anyway if there is no luck with the consultant and I still feel worried as it can't be good for any of us with how stupid and anxious nervous I am! However, I think I know what he will say (and it will be able not lashing out hundreds on unnecessary 'reassurance' scans plus the travel and time and what about DD when we have an MPV and twins' kit to save up for)

When I googled "private nuchal scan" to find the name of the one I went to in Leeds, there was an advert to say one had just opened up in Manchester, just off Deansgate? That might be closer.

I would definitely push at your consultant appointment for a reassurance scan given that you've been having cramps etc. For what its worth, I think you get more "niggles" with a twin pregnancy simply because there isn't as much room and one will probably have its foot stuck somewhere awkward. I relied exactly on what you say - that the medical staff would appreciate that me being a jibbering wreck was not good for anyone - when I wanted a scan after 12 weeks (my aunt had suffered from 'vanishing twin' syndrome - where a twin pregnancy becomes a single pregnancy between 6 and 12 weeks and because I'd had my dating scan so early, I was petrified the same would happen).

Good luck

Deansgate might be easier- if I don't get a scan this week, I will google and book an appointment. I'd be disappointed if I don't get one here though. I've convinced myself I could still have 'vanishing twin' and all sorts- in fact, I'm clearly losing the plot because as the consultant appointment gets nearer (4 days away) I almost don't want a scan, as I've convinced myself these really deep, sharb, stabbing pains was something very bad happening to one or both and want to believe it's all fine with both babies for a bit longer. I can't believe how mad I've become...