Restrictive growth in twins. IUGR

[Missluck693]

After the hospital initially diagnosed my Mo-di identical twins sharing a placenta with TTTS, they've now said it's selective intrauterine restrictive growth where one twin is growing slower then the other due to having a smaller share of the placenta.

I'm 22 weeks and the smaller twin is weighing 305g compared to 400g for the other twin. I'm still in type 1 and now I'm having weekly scans monitoring if this moves to type 2. Despite difference in measurements in femur, abdomen, head etc all other developments concerning organs seems fine and and the amniotic fluid difference is not significant.

I'm sick with worry as if situation gets worse they could ask me to make a decision to terminate one to save the other and this would be the worse position to put a mother in and I don't know if I can do it.
I'm also concerned at the prospect of a very early delivery that could impact both babies.

I was myself born in the 80s and born 2lbs at 32 weeks and encountered a retinal detachment due to too much oxygen but have had no health or development problems. This was in the 80s too.

I'm hoping to hear from other mothers who've experienced early diagnosis of restrictive growth in twins and how it went for you.

Just replied in the other thread. Sorry I can now read your full story and my reply isn't really very applicable!

I had this with my twins. It was stressful and hard but the important thing is that my gorgeous girls are now about to turn three! And they are healthy and fabulous. I hope this gives you some help. We were carefully monitored and managed to hang on until 34 weeks! Little twin was 3lb At birth and was quite poorly but she is right as rain now. The size difference has remained and can sometimes be quite pronounced but at least it helps people tell the difference between the girls. Wishing you the very very best. Btw there is a Facebook group for SIUGR which I found really supportive

I had a very similar situation, thankfully with a happy outcome.

My twins had SIUGR, caused by sharing the placenta unequally, and the blood flow to the smaller twin being pretty terrible. It was diagnosed at about 16 weeks, and, like you, there was talk of selective termination, or possibly of needing laser treatment on the placenta to protect the bigger twin if the smaller twin didn’t make it.

The consultant was very concerned about the blood flow, and I had to go for twice weekly doppler scans on the placenta throughout the pregnancy (which was fun!). At first we were just hoping we’d be able to scrape through to 28 weeks and deliver at that point. But somehow the blood flow stabilised, and the consultant began to talk about a 30 week delivery, then a 32 week delivery... And amazingly we made it through to a 36 week delivery and astonishingly healthy weights (5lb14lb and 4lb10!). The boys were in special care for a few days for a bit of help with feeding and blood sugar etc, but we were all home a week later! They’re 2.5 now, the smaller twin is still petite, but perfectly healthy.

It was a stressful time though - months of worry and constantly on tenterhooks for the next scan. I sympathise. Feel free to PM me if it helps!

I was unfortunately in exactly this position: diagnosed with TTTS first of all but it turned out to be sIUGR. It was a horrific time however after a premature delivery and significant NICU stay I now have two beautiful healthy twin toddlers♥️ hang in there x

Thanks for sharing your good news. Update on my situation;

I am now 28 Weeks. Both babies have grown only hundred grams in 2 weeks. Their growth is slowing down even with baby 1 who was still in the 12 centile until now and his growth also being affected so now both off the charts. Baby 2 is in less than the 1 centile. At the last scan hospital said we need to deliver in a fortnight (30 weeks or earlier if medically required). They currently weigh 880 and 670 grams. I don't know how much more they will grow. So both likely to be less than 2lbs when born.

I'm especially concerned about baby 2 who is not yet even 1 and half pound. The Dopplers are steady with areas of low flow for baby 2. Others markers ok. Anyone with experience similar to this?

I had AED (related to low flow to the gut) for twin 2. It was caught at 32 weeks after much nagging (won't bore you with that.
Are you able to get a scan from the foetal medicine department. Standard scan will not tell the full story.

I had SIUGR suspected from 21 weeks. Mine were Di-Di and boy-girl. We had genetic testing to rule out any chromosomal disorders with the boy who was growing much slower than his sister. These came back negative and his growth continued to slow, and eventually stopped. I was monitored every two weeks by foetal medicine until at 29 weeks there was only one heartbeat. I safely delivered the girl at 36 weeks following a spontaneous labour. She is now ten months old and doing great. This was the least worst outcome - I think I would have found selective termination incredibly difficult. My heart goes out to you, it is such a difficult time and I pray your babies both make it.