is there an ob/gyn in the house?

[loopyloops]

Hi there

A couple of these questions I've already posted in bereavement, so sorry if you have read them already, some new ones though.

DH and I are considering TTC. DD is 14 months old and still breasted (3 times a day usually). She was a fraternal twin, tragically her twin sister was stillborn at 32 weeks, resulting in EMCS and 32 week prematurity of DTD2.

Obviously, I have many concerns if I am to get pregnant again.

*Will I be treated as high risk due to the previous problems? Will I have more scans etc?

*I have heard that having fraternal twins increases your chances of having them again from 1/80 (normal population) to 1/20. I have also read that breastfeeding when becoming pregnant increases chances of conceiving twins 9x. Does this mean I will have a 45% chance of conceiving twins again?

*I have read that in high risk pregnancies it is advised not to breastfeed the older child. Is this true?

I appreciate that these questions are very specific and might not be answerable. In which case, who should I ask?

Many thanks :)

anyone?

its always really quiet on mn at the weekend try bumpimg tomorrow after school run sorry but have no advice for you but didn't want you to go un read

Thank you :)

I can't really help but didn't want you to go unanswered. I do know from friends who have had stillborn babies that they are treated as "high risk" in subsequent pregnancies, which in their case has meant scans every week for one of them and every 4 weeks for the other, and a consultant rather than midwife led delivery. Also, neither of them were allowed to go past due dates - so one was induced because she hadn't gone into labour then. I think they will keep a very close eye on you if you get pregnant again even if its a single baby rather than twins. Good luck with everything.

Loopy - not an ob/gyn but a m/w so can kind of answer some poinjts, maybe.......

First of all I'm sorry about the loss of one of your twins. Did they find out why? Some things such as a placental problem may mean you are higer risk for a future pregnancy where something else such as twin to twin transfusion would not mean that you were high risk again (unless it was twins again). However where I work anyone who has had a previous stillbirth at your stage of pregnancy would be offered extra scans if only for reassurance. Not sure if this is the same at every hospital.

I have never heard of b/f increasing your chances of having twins but fully accept that it could be true. However I would be amazed if that meant that you would have a 45% chance of having twins again by combining both "risk" factors even if the b/f link is right. I don't think that statistics work like that by adding both risks together.

There is research that says if you're threatening to go into premature labour then you shouldn't b/f as b/f releases oxytocin hormone which is also a factor in the start of labour. But not all high risk pregnancies will mean that there is a threat of premature labour.

I think to get specific answers you would be quite entitled to ask your GP for a referral to an obstetrician at your hospital. They would be able to put a plan of care together for your future pregnancies and be able to decide how many extra scans they thing would be suitable, etc.

HTH. Good luck.

Thank you so much :)

Viva - do you know if you can ask for an early scan at your hospital? I am really stressing about the twin thing...

Firstly i'm so sorry for your loss.

I can't answer your questions about twins but i would tend to agree with the post above yours that i don't think your chances of another twin pregnancy would be that high, adding the 2 risk factors together.

Sorry to be intrusive but did the doctors find a reason for your stillbirth?

I had a stillborn DD at 35wks due to a concealed abruption. I did get a few more scans with my next pregnancy & i was induced at i think (bad memory)37+5. They didn't want me to go full term.
Whilst being induced i have another abruption, massive blood loss etc but thankfully my 2nd DD was saved.

With the following 2 pregnancies i had scans every 4 weeks (growth & doppler scans) & had to have my babies by elective c-section at 34 weeks, due to having a very high risk of a 3rd abruption (45% chance) .

So yes i would think you too would be classed as high risk & you'd should also be seen by your consultant rather than a midwife.

With early scans they normally do these for bleeding, pain etc so i'm not sure if they would give you an early scan just to check if you were carrying twins.... although there would be no harm in asking, if you don't ask, you don't get.

Hopefully someone will come along & might be able to answer your question regarding twins & the breastfeed.

Thanks Serendipity

The pm came back inconclusive but IUGR (growth retardation), unknown cause. So nothing specific to watch out for this time.

So I presume your 4-weekly scans were after 12 weeks? Did you have MW appts in between? I guess in that case it's the same level of care as fraternal twins. Hmmph. I just don't know if I can do it all again without going insane. How did you cope?

You can certainly ask for an early scan, think it would be up to your GP at a really early stage whether they refer you or not. Thats how early scans work at our hospital anyway. Like previous poster said, severe pain and/or bleeding are the standard reasons for an early scan but I think you would have a good reason for requesting one.

What sort of level of scans/appts are you wanting? Sorry can't work out if you want extra appts further on in your pregnancy or if you'd find extra appts/scans stressful.

Hi.

No the 4 weekly scans weren't from 12 weeks unfortunately.... i do love having the scans as it does help me stop worrying so much.
I get the normal 12wk & 20wk scans & then scans at 24,28 & 32wks. I would get a 36wk scan but i have to have my babies at 34wks.

To be honest i don't feel like i get any special treatment, no extra appointment to see my consultant.

I'm currently 23wks pregnant. I was seen at the epu weekly from 4wks - 12wks as i'm a recurrent miscarriage patient + had an ectopic last year.

I had my 12wk booking in appointment, then i had an appointment at 16wks which was when i got to speak to my new consultant. I'm having my next scan this week for growth & for the doppler scan & then i'll see my consultant this week too.

The only other thing i've had done in my last 2 pregnancies (the pregnancies after the 2 abruptions) is a 28wk appointment for glucose test. Other than that i don't get any extra appointments with the consultant.

The extra scans are nice & i'm glad i get them. However i suppose having extra appointments with my consultant won't really do me much good as theres no way of telling if i'll have another abruption.

I love being pregnant, for me its such an amazing experience esp after all the losses. However on the other hand, although i don't show it to my husband & family, i am so scared of something going wrong.
I just hope & pray that every pregnancy will be ok & that i'll get a healthy, live baby at the end of it.
I start to worry more later in pregnancy but i just have to carry on & get on with it. Its always in the back of my mind what can happen which is sad because you can't fully enjoy pregnancy like other ladies.

x

Oh god, I know I'll want scans every day!
Obviously that isn't going to happen!
I had a 28 week scan that was awful, the sonographer noticed there was a problem but didn't write it in my notes. When I freaked out and asked the consultant, because it wasn't in my notes didn't believe me so didn't have another scan until 32 weeks, by which time she had died. So I'd like to know I'm getting better care than that, but I can't guarantee it, can I?

Loopy

As well as scans we have an antenatal self referral centre which is open 24/7. Women can self refer, now normally they have to have a reason to come in, can't just ring up and say they fancy having a monitoring.

However if any lady rings up, upset after having a previous IUD or has a high risk pregnancy this time and is just scared I would definetly say come in and be monitored and have done so many times. Women have found it reassuring to come in and have the baby's heartbeat monitored for 30 minutes.

Thank you so much for your help, it really makes the difference :)

Thats ok, really hope you get a plan put in place which is OK for you. I'm sure any future pregnancy will be an anxious time for you no matter what. Rememeber though whatever scans/etc they do for you don't over rely on them. What I mean is if you're worried about movements one day don't think that if you had a scan the previous day and that was ok then baby would be fine. The most important thing in pregnancy is to listen to your own body and especially be aware of movements. I'm sure you wouldn't but I have known people do this before. And especially people who have bought their own doppler, they're worried but have a listen in, find an FH and think everything is ok so don't ring us.

I do not think I can really help much at all sadly Loopyloops, but I wanted to reply anyway.

I am so sorry you lost one of your twins. Obviously my situation is different, but I feel so much for you and how hard it must have been and must still be.

Despite all the figures given out, my consultant has told me it is rare for women to get pregnant with twins twice. (I have been pregnant with twins twice) Most 'lay people' seem to think this is nonsense, but I have heard of other twin Mum's being told the same by their consultants. Certainly I had three singleton pregnancies prior to my twin pregnancies and my last (very recent and sadly ending in a MC) pregnancy appeared to be a singleton at an early scan.

I think most hospitals like to treat ladies who have had a loss with kid gloves even if they aren't considered high risk. I know I will be considered high risk in future pregnancies and monitored accordingly, but I think that varies not only from hospital to hospital, but consultant to consultant.

I understand how worried you must be. I think maybe if you see your GP they can refer you back to your consultant for an appointment prior to you trying to concieve if you think that would help? Maybe they can give you accurate information on the likelehood of another twin pregnancy and the breastfeeding etc? I think the thinking on not breastfeeding in a high risk pregnancy comes from the fact that nipple stimulation is thought to possibly induce early labour if there are other risk factors, but I am not sure if this is just an old wives tail?

I hope you get the answers you need. We are planning on TTC again soon and it is absolutely terrifying.

Thanks Viva, you're a star for all your help.

Midori, thank you so much for coming over here, and for your help. I am so sorry about your miscarriage and for demanding your help when it's probably the last thing you want to think about.
I think an appointment with the GP is what I'll do, I don't expect them to have any answers but I guess they will refer me to someone who does. Good luck, I hope it all works out for you. :)