MCDA twins, polyhydramnios, early TTTS?

[snowsuit]

I'm wondering if anyone else has any experience of this or can reassure me. I'm 24+3 with MCDA twins and everything has been perfect at all my scans so far, but at my scan yesterday the sonographer mentioned that there was a lot of fluid around one of the babies. They are still growing at pretty much the same rate - almost bang on the 50th centile - but one has 8.3 cm fluid, the other 6.7 cm. The consultant didn't seem too worried but he re-did the scan in his room, and got 7.7 cm for the largest measurement - he was very laidback and said it was now in the range of normal technically, but did say 'that is probably more fluid than i'd expect to see'. He wanted to leave the next scan for 4 weeks as originally planned, but I pushed for 2 and having now done a bit of research I'm glad I did - it seems like this fluid level is definitely not normal at 24 weeks, especially when there's the possibility of TTTS.

Everything I've read has TTTS developing or at least starting to show signs earlier than this, so has anyone had it show up after 24 weeks? And has anyone had it start like this - with too much fluid around one twin, without too little around the other? I'll be 26 weeks when they see me next - has anyone had the laser treatment at this stage, or would it be too late? Or has anyone with MCDA twins had polyhydramnios that stayed stable?

Ugh. I just feel beaten down by this pregnancy. Having some quite negative thoughts about it all

Sorry you are having a difficult time. I have no personal experience, am also expecting MCDA twins but only around 18 weeks at the moment. Sounds like a very stressful experience and I think you absolutely did the right thing by pushing for a scan in 2 weeks. I have been told that's what I will have throughout the pregnancy. The only thing I was wondering about was if you had had a look at the Royal College of Obstetricians Green Top Guideline? There is one for MCDA twins (number 51) and a section in there is specifically about TTTS I think it might be pg 5 and it mentions something called the Quintero classification and from the measurements the consultant gave you on the rescan it does sound more reassuring. Some of the Guideline is a bit technical but at least it does give some info and maybe can help guide your questions etc at the next scan? Did they mention seeing babies' bladders etc?
Hope things go smoothly for you and your babies.

thank you for your reply, it's good to know there are other people out there having MCDA twins! i hope everything's going well for you, do you know what you're having yet? i will take a look at the RCOG guidelines, that's a good tip! that's great that you're getting scanned every two weeks all the way through, i've had two-weekly scans up until now but it was supposed to go to every four weeks now until the end, and the consultant made me feel like i was being precious by asking for one sooner. he did say that he could see both bladders which i realise is a positive sign. i'm just stressing over an uncertain two-week wait and hoping that the fluid discrepancy doesn't mean that TTTS is on the cards somewhere in the future, but i'm trying to be positive... feeling quite eager for this pregnancy to be over but obviously want to hold on for a good few weeks yet!

Well done on pushing for a scan in 2 weeks. I gave birth to mcda twins in november and all was ok. The discrepancy doesn't seen too bad at the moment especially considering the higher reading but know you must be stressed. And I thought the real issue is when the level of fluid gets low - i seem to remember mine was different between the babies but both at good levels.

Not sure where you based but I had additional scans at fmc at harley street as well. Good luck. Another 4 weeks and you should be over the riskiest time for ttts.

If I remember correctly the Guideline recommends scans at 2-3 week intervals so you could always bring up that wee nugget as reason for more regular scans? Tell him you've read the green top guideline!!
Yes always nice to hear of other MCDA twins and also from you lion that all went well with yours. We don't know what we are having yet. I like surprises and dh doesn't, he prefers to plan, so not sure yet whether I will let him have his way or not! We already have girls and a boy so no real preference or anything. Have you found out yet?

thanks lionsleeps and congrats on your twins! it's really nice to hear that you had them without any problems - i've been doing too much googling lately and it's easy to forget that it isn't always complicated! a private scan sounds tempting but i'm in norwich and can't really get down to london at the moment. i generally feel pretty well looked after but it seems to depend a bit on what consultant i see, one is very thorough and seems to really know his stuff and the other one is a bit more laid-back. hopefully i get the on-the-ball one next time... surf yes i will go in armed with the guidelines, can't do any harm - although i'm obviously hoping things will just go back to normal and i won't feel the need to press for lots of extra monitoring. we are having two boys - aargh! i already have a DD and before i had her i always imagined having boys, but after six years of having a girl i feel like i won't know what to do with boys! i'll figure that out when they're here, right?! good for you for not finding out - we were thinking of leaving it as a surprise but curiosity got the better of us and i am quite glad i know now - feels like one less 'unknown' IYKWIM!

Snow google is not your friend when you are having twins!! I know what you mean about different consultants - at my hospital both consultants I saw were great but one seemed to scan so fast. Tamba information is great as well as the nice guidelines and def push if you need to - I had scans every 2 weeks and then every week towards the end as they were keeping an eye on the smaller twin.

We found out at 13 weeks we were having 2 more boys - the sonographer said they were 70% sure it was boys. I jad so many scans that I think it must be hard to have a surprise with twins.

I know it is hard but I tried to only worry about things that happened. When I found out we were having twins I was so scared after googling convinced that they would get ttts and then worrying about the delivery too. Of course there are more risks with a multiple pregnancy but all you can do to a certain extent is eat well, rest and try not to worry too much. Good luck.

Hi! I've got MCDA twins too, it's so hard not to worry isn't it!

I do think you should be having fortnightly scans from what I read/remember though.

I didn't have any problems but did get lost of useful advice from the "Modi Twins" group on Facebook. It is well worth joining for a read through their pinned files and there are a few posters that seem to know their stuff a lot better than I do and could probably help/advise you if you post about your situation there!

Good luck luck! I

Hi

I have MCDA twins, and we had TTTS diagnosed at 16 weeks so no direct experience of it developing later. Mine was extreme and I was lucky enough to be in the right place at the right time and had successful surgery within 4 hours of the first diagnoses.

From what I recall you should be having fortnightly scans anyway in a modi pregnancy. Are you under a feotal medicine centre? If not I would be pushing to get seen there if you can (assuming there is one relativley near). I found my local hospital pretty useless and one of the sonographers had no idea what TTTS even is.

for you, its very stressful.

thanks aldi. must have been terrifying for you, glad to hear that you got the surgery quickly though and that it worked for you. i'm not sure if my hospital is a fetal medicine centre or not, it is a big teaching hospital though. i think they refer to london for laser surgery etc.

i did a lot of research this week and feel slightly calmer - also 1 more week down, 25+4 now! it seems like laser surgery could possibly be an option after 26 weeks depending on the location of the placenta - and the consultant already told me mine was in the 'best' position (whatever that is). so i have that in the back of my mind as a plan... i just can't face the thought of them being born super early. but am hoping for a good scan next week to buy another few weeks of time...

Hi snowsuit was just wondering how things are?

hi surf! i had a scan the week before last and nothing had changed - exactly the same fluid levels ie one too high, but they did the dopplers which were both good. i moved seamlessly from being quite relieved to stressing about the next scan - which is this thurs, eek. have been feeling huge this weekend and was in two minds about whether to go in as they told me to report getting a lot bigger, but haven't actually put on any weight, and i'm not in pain as such, just feeling v ungainly, so am going to see how i feel today and tomorrow.... how are you doing? i guess you must be about 24 weeks now? how are you feeling?

i just got a birth announcement from my friend which said 'we are all coping well and are very happy, but i have no idea how you're going to manage this with 2' well thanks for that vote of confidence haha! i'm so focused on the pg it's easy to forget that i'm going to have double babies to cope with at the end of it....!

Stay away from Google

I have twins there was a big flap at one of my scans as the nurse thought one of the babies had lost weight (around a lb) and the other seemed to have gained weight.....
can you see what happened I did
I was admitted had traces done extra scans lots of people uming and arhing.
Until it was finally decided that the twins had swoped positions.
I was also told my babies would be very small they were 5&7lb - after a couple of months they were the chubbiest babies I have ever seen

Hi snow glad the scans and dopplers have been good. I am finding it both reassuring and anxiety inducing to have scans so often in a funny kind of way! I am just at 21 weeks now so time seems to be moving quite slowly! But all is going well so far so that is absolutely the main thing! Yes that's not the most helpful message to get from your friend! Although I have to say that I find most people's reactions are more about them than they are about you, if you know what I mean! People who look at me in horror or say all sorts of rather negative things, I think it is that they might be horrified/shocked/scared etc to be in my position rather than actually any reflection on how I am actually feeling about everything!!! I am sure it will be hard, but we'll get there!
Hope your scan goes well this Thurs!

I'm glad everything's going well for you! Weeks are crawling by for me too, but we'll get there!

It's interesting the range of reactions you get, isn't it? Some of my friends have been so positive and lovely but I've had a couple of funny reactions - one of my friends let out a massive reflex 'oh no!!!' And was then completely mortified, which I didn't mind, but another friend was so negative and really upset me- told me how she always dreaded twins, said 'you won't be able to work again obviously' and spent ages telling me how all the twin mums she knew were miserable and exhausted. Although it upset me at the time I thought about it later and just thought - how bloody rude!! Although both my mum and MIL are being relentlessly positive and that is really getting on my nerves in its own way so I think I'm probably just overwrought and hormonal

Had scan on thurs, consultant was amazingly thorough and scanned and rescanned everything- fluid still too high so I have to have the diabetes test which doesn't sound so fun. Also increased PI in one of the dopplers which I Googled briefly, felt terrified, and then decided to leave alone for the sake of my sanity...

Hope all is continuing to go well for you!

Twinkle that's funny about your twins- I actually asked last week if they could swap sides as I feel big sweeping kicks across my belly sometimes, but got a very condescending look from the consultant! 5 and 7 lb are amazing weights, were your twins mcda?