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Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Twin-Twin Transfusion Syndrome

320 replies

MrsStevo · 11/04/2011 15:25

Hi!

I wanted to share my experience of the most horrendous week of my life and find out if there is anyone else out there in the same / a similar boat?

My MCDA (identical) twins were diagnosed as having Twin-Twin Transfusion Syndrome (TTTS) at my 20 week scan last Tuesday (5th April). The doctor established this because one twin was smaller than the other, had virtually no amniotic fluid around it and was stuck to the wall of my uterus, not moving. It had a heartbeat but no bladder could be seen (as no fluid for it to drink / urinate). The other baby was swimming around in waaaaay too much amniotic fluid. The doctor thought I was at stage III of the condition (Stage V being babies have already died) so very serious.

So, I was referred to Birmingham Women's Hospital (I live in Lincoln) and had an appointment there on Wednesday afternoon. The (amazing) consultant - Mr. Bill Martin - scanned me and confirmed TTTS. He said he thought I was actually only stage II but basically said the only chance babies had was for me to have Fetoscopic Laser Ablation Surgery - keyhole surgery where they go into the sac that the bigger baby is in and laser / cut off some of the blood vessels in the placenta that the babies share so both babies have their own half. Odds are 40% chance of both babies surviving and 80% of one surviving. Plus added risk of early labour / waters breaking, infection etc.

Long story short, I was admitted to Birmingham Hosp on Wed PM and had the surgery at about 9am on Thursday. I was terrified - had to have spinal anaesthetic, be catheterised, wear a surgical gown and it was done in a big operating theatre with literally 15-20 people in it. However, my consultant was just amazing - so re-assuring and acted as though it was something he did everyday. He and his colleague were even chatting away about holidays whilst they lasered away.

After the surgery we (DH and I) had to wait for 6 hours before they would scan me again to see if the babies had survived the surgery. At the time, that was the longest 6 hours of my life. We had the scan at about 5pm and both babies were alive - the doctor said they looked healthy and it was the best outcome they could hope for. However, they also said that the next week is a crucial time and, if babies survive the week, then that is really good and indicates they both have a good chance of making it.

So. Here I am 4 days post-surgery with 43 hours until my next scan (they're doing it a day earlier in Lincoln so I can see my consultant there). I feel completely lost and totally in limbo. I don't know what to do with myself (aside from rest, feet up etc etc) but am just trying to stay sane. I'm trying my hardest to keep myself away from Dr. Google so I don't freak myself out by the statistics.

The biggest things I worried about right now:
Will both babies survive? I can't imagine my life without having twins in it now -these will be our first babies, having had a miscarriage last year.
IF they do survive, will they have any neurological damage as a result of surgery - cerebral palsy is a risk. How will we cope if they do?
I'm vegetarian - should I be on protein suppliements to promote healing / good blood quality etc?
Is there ANYTHING I can do to make the odds better?!

Oh. It is just a horrible time. My DH went back to work today (although he wants to be at home with me as much as I want him to be) so I'm alone with just my overactive mind (and a pesky cat) for company.

I wanted to write about this experience on here in case anyone has any pearls of wisdom or wants to share their experience of this horrible condition. Or, if anyone on here happens to be an expert in this condition, perhaps they can pump me full of optimism with a bunch of statistics that everything will be ok?

Thanks for taking the time to read / listen.

OP posts:
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silverangel · 20/07/2011 16:40

No problem at all Twinnes - we all know what its like to be panicking about something! My husband is in complete agreement with Mr Twinnies, he thinks every week, even every two weeks, is too much and that we know far too much about what is going on.

Had my appointments today - scan all good, growth still going well. They are 1250g and 1310g now. Booked in for section on 1st September, will be 35+5. It feels really good to have a date to aim for now and I think for the first time I am starting to let myself think that this could all work out ok! Back again in two weeks.

x

twinnies26 · 20/07/2011 19:00

hi silverangel delighted for you that all went well today - and you have a date booked now how amazing! - you are heading towards the end now! Not a long time to go at all really :) Good babies growing so nicely for you!xx

CakeForBreakfast · 22/07/2011 14:38

Hello everyone,

I have had a scan today. Not an entirely clean bill of health for my twins I'm afraid. Do you remember I was worried that last week that one twin looked a little like it was wasn't growing as well as the other. This week, the tables have turned, that twin has now overtaken the other in terms of fluid levels (and growth).

The consultant is suspecting reverse TTTS albeit much milder than before. No affected dopplers, babies seem fine so far, just needs monitoring to make sure it doesn't increase pace. He said this milder form can be quite common when laser treatment has happened early (I was 19weeks) So continuing weekly scans for me.

Oh well. It never ends does it!

How are you all?

xx

twinnies26 · 22/07/2011 15:02

gosh Cake so abit of stress for you again,sorry to hear that. Funny how in one week the tables can turn so quickly.

So reverse TTTS- well it's good dopplers are fine and i guess if things change they'll be picked up quickly with weekly visits.Did he say what would be done if things don't even out?Are you also looking at possible repeat surgery or amnioreduction? That's what my consultant said on Tues if growth doesn't pick up. I'm like you, had the surgery at 17+2 very early too so interested to know as well.

Guess we just all have to try to stay strong and think positively - even though it's so much easier said than done. I admit I've been abit wobbly since Tuesday again!

I did have a nice moment yesterday - twin two decided to stick her bum or belly out for the first time and i had this funny bulge going across the side of my belly! First pregnancy so get pretty excited about things like that! :)

CakeForBreakfast · 22/07/2011 18:34

Hi Twinnies

Yes, he suspects reverse TTTS, but not 100% certain. So the previous donor twin has just overtaken the former recipient in growth now whereas before she was always a bit smaller! (They are now 1 lb 8oz and 1lb 7oz by the way at 24+4).

He did suggest that occasionally they do a repeat laser if it seems necessary or amnioreduction. He did say though that it would have been more worrying if this had presented itself soon after the laser treatment rather than weeks after, so at it stands its fine, just needs to be monitored. I will have to hope that next weeks scan does not show any escalation, especially as my consultant is on his holidays for the next 3 weeks and I'll have to see someone I don't know!

I'm sorry to hear you are were a bit wobbly, how are you today?

the bulge thing - my goodness, its mad isn't it, it looks (and feels) so odd!

xx

MrsStevo · 23/07/2011 12:59

Hi all!!

MY BABIES HAVE ARRIVED!!!!!!!!

My darling little twin girls arrived at 35 weeks and 1 day on Wednesday 20th July at 10:25am and 10:29am! First baby out was Madeleine Abigail weighing 4lb 4oz, followed 4 minutes later by Sophia Tara who weighed a tiny 3lb 6oz. They arrived a little earlier than scheduled as they broke their waters at 2:30am. No contractions or anything hideous like that but after the waters went the consultant wanted to deliver them asap so it was an ERCS in the end - but all very calm and wonderful.

Both are just the most perfect little babies in the whole world (biased, I know). They are both in special care due to their birth weight and history of TTTS but they are doing superbly and consultant is very happy with their progress. They had quite a few tubes etc to begin with for drips and stuff but both just have tube feeds now and everything else is out. Madeleine is in a proper cot now but Sophia still in an incubator for now to keep her snug until she podges up a bit! I was discharged yesterday but they have rooms for parents in special care so I've just moved up there to be near my girls.

I can't even begin to describe how proud and extremely in love I am with these perfect little beings. Getting all weepy just typing the words. When I'm home again I'll upload some photos so I can show them off.

Can't catch up with everyone else's news now as I need to get back to my babies.... can't bear to be apart from them. Hope you're all really well and all your twinnies are behaving themselves. Me and my girls are finally living proof that this horrible condition can be overcome - I wish you all the best and hope you all have the same outcome x x x x x

OP posts:
CakeForBreakfast · 23/07/2011 15:06

Oh my goodness!!!!!

MrsStevo I can't believe it - they're here! What beautiful names too.

Wow wow wow. Congratulations to you and MrStevo. How proud you must be.

I'm sure now will be very busy but any update on how you and the girls are, let us know. How are you feeling?

And yes, pictures would be even more wonderful! How exciting!

silverangel · 23/07/2011 15:54

Oh wow Mrs S, huge huge congratulations to you and Mr S and welcome to the world Sophia and Abigail. So so pleased for you, made my day to read that:)

Hope that Sophia catches up with her sister soon and you recover from the section quickly.

CONGRATULATIONS!!

Xx

twinnies26 · 23/07/2011 21:39

WOW!!!!! what amazing news!! - huge congratulations to yourself and Mr Stevo! I'm SO happy for you :) :) and so delighted that the girls are both doing so well! Love the names too!!

WOW!!! what a surprise didn't expect to see that when i logged in!!

Can't wait to see pictures - but whenever you have the time, your hands will be pretty full now looking after your little bundles of joy! ;)

Keep us updated on how you are all doing!
Much love xxx

twinnies26 · 27/07/2011 11:39

Ladies,

how are you doing?

Cake have you been back in or is it Friday??Hope it goes well anyway, will be thinking of you x

silverangel · 27/07/2011 14:55

Hello,

All good on my front - no hospital appointments this week which still feels odd, back in next Tuesday. Back is soooooo much better, have just got back from Bluewater and walking round there would have been unthinkable a couple of weeks ago. Starting to freak out a little about pre-term labour, have slapped a drinking ban on DH from this weekend just in case. He thinks I'm being neurotic, which to be fair is probably true:) Have also headed back to tiredness like the first trimester, am waking five or six times in the night now to go to the toilet so seems by kicking my bladder they are getting me ready for the sleep deprivation once they arrive!

Long story short but I got chatting to someone the other day who's wife had id twins, TTTS, had the surgery at 20 weeks, at 27 weeks delivered pre-eclampsia quite badly - she was delivered there and then. Anyway, nine weeks later, mum and one baby home, second baby still in special care but doing well and should be home soon. So, moral of the story, I think any one who has been through this has little fighters!

Hope you have good appts this week Twinnies and Cake and Mrs S, you are probably up to your neck in things but hope all is going well.

xx

silverangel · 28/07/2011 21:32

Me again ladies, just thought I'd give you an update on my antics for last night! I started getting strong pains at the bottom of my bump last night, definite cramps that were coming in a consistent pattern - phoned the labour ward and they said should go in to get checked out. Went in and got hooked up to the monitor, they did pick up some tightenings but did an internal and all was fine - def not in labour. Apparently something called irritable uterus and pretty common in twin pregnancies as they develop as uterus is pretty much stretched to capacity already and still has to further!

Anyway, I had never heard of it so thought I would let you know in case same happens to any of you. Absolutely fine today, but they did say it could happen quite frequently now.

X

CakeForBreakfast · 29/07/2011 10:01

Morning everyone,

Silver that must've been quite nervy - the irritable uterus thing, do you have to go back in every time it happens? Thanks for the heads up.

Later today I'm back in for a scan. It has ben preying on my mind again, I have been gently preparing myself for needing more procedures, we coped when I had to have laser surgery so I know we can again, and I have just about reached viability so....

...anyway, I will let you know how it goes.

MrsStevo still thinking of you and your little girls, hoping they are getting nice and fat.

twinnies26 · 29/07/2011 12:06

hi ladies,

Cake good luck today, am thinking of you and hoping you won't have anything to worry about. I have also been trying to prepare myself to hear something similiar this Tues, although i'll probably still crumble even if they say it. Almost 26weeks Cake? you're right we're almost viable, although y consultant said delivery is not an option until i reach 28. Maybe that's their hospital policy?I guess i'll know more next Tues.

Can i ask you both about movement in your twins? Do you have one twin which is more active than the other? Can you clearly distinguish who is moving all the time?? Sometimes i find i can't tell for sure who is kicking - maybe when i'm later in pregnancy it will be easier to tell?As far as i can gather twin 2 is very very active and twin 1 is much quieter for me (she's the smaller one) I actually went to the GP few days ago to get heartbeats checked as i was worried twin 1 was not moving enough :S

Silverangelthanks for the heads up about irritable uterus - hope it doesn't become too much of a regular occurance for you. You have almost a month to go now yes? You're almost there! you are 30 weeks now yes?

xx

silverangel · 29/07/2011 12:38

Cake - good luck today, let us know how it goes. They didn't say I would have to back in but in my neurotic state I may well do just to confirm its not labour! One of the midwives said labour pains will be across the back as well and not localised at the bottom of bump as well.

Twinnies, I am 31 weeks tomorrow and I drive myself insane worrying about movements. Twin 1, the smaller one, is head down at the bottom and twin 2 is oblique across the top of my bump. 2 definitely moves more now but at around 22 weeks it was the other way around. Also I find that if I sit up and lean forward I can feel number 1 and if I lie down I can feel number 2. They seem to move in the morning when I wake up and after I have my dinner but not too much in between. Earlier on I found that if I looked at my belly I could see it moving even when I couldn't feel it. I'm a size 16 and I do wonder if the smaller you are the more you feel and also with two on board they are obv more restricted than if there was only one which must affect movement? I also remember around 26 weeks panicking I hadn't felt the top one as much and he said it was to do with position and being all tucked under my ribs...

X

CakeForBreakfast · 29/07/2011 20:50

Hi,

No new developments from todays scan which is a good thing really. Still unequal fluids, but dopplers all good, growth scan will be next week.

Movements are plenty so far but I am finding it harder and harder to tell who is who and where, especially as they grow, todays scan showed their positions were absolutely different - almost the opposite to what I had thought they were.

I have one (smaller) transverse along the bottom but towards one 'corner' and the other all over the place on top, which surprised me. Like Silver, if I bend forward, the bottom twin lets me know thats not on, the other is very active and bulges and wriggles (Have you ever seen the movie tremors, its a bit like that under the skin!) What I do notice is that each seems to be awake at different times.

xx

MrsStevo · 30/07/2011 17:38

Hello again! I've popped home again for an hour... life at the hospital is fairly chaotic and I'm itching to get the girls home now.

They are both still doing really well - both in proper cots now and sleep in my room with me. The only reason they're still in hosp at all is that they aren't quite back up to their birth weight yet and they are still getting the hang of breastfeeding (as am I!). Hate to be the bearer of bad news, but breastfeeding twins is bloody hard work!!!! But totally worth it as it is an amazing feeling.

I still haven't had the time to read through all your news but I hope you're all ok. I did read something about reverse TTTS for someone (cake?) - I had a similar issue and the doctors suspected reverse TTTS but actually they just balanced themselves out again after a couple of weeks without any intervention. Hope yours do the same.

Anyway, I have to dash as Sophia needs feeding AGAIN at 6.... I am just a milking machine at the mo! x xx

OP posts:
MrsStevo · 30/07/2011 17:42

PS - have uploaded some pics now so have a nose. A warning tho - the girls had lots of wires and machines attached to them initially so the first photos are a little scary but it wasn't for long.

OP posts:
silverangel · 30/07/2011 19:29

Damn, I'm on my phone so can't see your pics but will have allo on computer asap Mrs S. Glad they are both doing well - do you have an idea when you will all be allowed home?

Good news cake - my fluid has been different too, not by much but both within the realms of normal.

More drama yesterday on my front, had a show so back up to the hospital,m they kept me in overnight for observation and everything seems ok, cervix still closed etc so def not in labour! Have been ordered to rest, properly. They gave me the steroid injections, have to say they stung a bit but not as bad as I expected. Also tested +ve for GBS, the midwife was unsure of the implications for elective section but will discuss with the consultant on Tuesday. I have a very strong feeling I am not going to make it to the 1st September!

X

silverangel · 30/07/2011 19:35

I lied, phone worked on the pics! Your girls are beautiful and you and Mr S look so chuffed. Huge congratulations again! Xx

twinnies26 · 30/07/2011 23:57

Hi all!

I can't seem to see the photos? :( Are they attached at bottom of Mr.Stevo's message?

Mr'S I'm SO glad the little girls are doing well! :) and delighted you are breastfeeding - i really want to try to breastfeed them too! I' sure it is alot of hard work, but think of all the goodness you are giving them in their first days!

Cake glad all went well for you at the scan at least you can relax for another week now.

Silverangel sorry to hear more drama for you, hope you are staying calm anyway and now going to rest as much as you can! do you have some people who can help you out with basic day to day things so you can really rest up?Let us know how you go on Tuesday.

X

twinnies26 · 02/08/2011 13:21

Hi ladies,

hope all is well!
silverangel how are you doing?I hope no more visits to hospital over the weekend.

Cakeall ok with you?

Mrs Stevohope the girls are continuing to thrive and that you are feeling much better after the CS.

Thought i'd give my latest update - as suspected twin 1 hasn't grown enough for me, the difference between the girls is now 16%. (Twin 1 is 579g 1lb 4oz Twin 2 658g 1lb 7oz at 25weeks +2) My consultant is happy enough not to consider repeat surgery as fluid and dopplers are all good, but once the difference hits 25% or close too it he has said they will come out.

I'm to start steroid injections next week and will be in every week now to monitor growth. He's still hoping to just get us to 28 and says at the moment he really doubts we'll get past 32weeks because of recent growth patterns. Despite all this he reassures me we're doing ok....guess it's just as unpredictable as ever.

Anyway, I hope i can get at least to 32weeks but my bag will be packed from Tues week incase i don't come back from one appointment.

Am surprisingly calm and not flustered with it all today, i suppose that's a good thing anyway!

We'll just see how it all folds out in the next three weeks.

X

silverangel · 02/08/2011 19:34

Hello all,

Well, my babies are here! Alice May, 3lb3 and Sophie Isabel, 3lb5, born last night at 2209 and 2210 be emergency section at 31+2. They are doing very well, have been taken off oxygen, still in incubators and having phototherapy for some slight jaundice. Biased I'm sure but they are adorable.

All happened rather traumatically though, ended up in hospital again on Sunday night with pain and bleeding, the bleeding got quite bad overnight and I started to have contractions. Long story short, I had to have a blue light transfer to Ashford (hour and half away from where I live) as it was the only place with space for two under 32 weeks, had a huge bleed and whipped into theatre. The twins were never in distress, turns out I had placental abruption and they estimated I lost three litres of blood. I am fine now after a blood transfusion and even though it was an emergency, the section was a great experience, the team were fab and really relaxed.

Twinnies, hope they stay in as long as possible, the consultant here keeps saying it was such a good job we had had the steroids.

Xx

twinnies26 · 02/08/2011 20:53

Oh my goodness!!! Funny i had a feeling that maybe you're babies might have arrived - what a drama for you having to be transferred like that and losing so much blood - must have been a bit frightening - but i'm SOOOOO glad you are doing well :) and that the girls are also doing very well,great the girls are off oxygen already! :)

I'm so happy for you that you're two little bundles of joy have arrived safely :) and i love their names - Isabel and Alice are also some of the names on our list!

Keep us posted on how you and the girls are doing although i know you'll have your hands full just like Mr.S now!

2 ladies down - 2 ladies to go! Fingers crossed myself and Cake can also have the same good results as both of you!

I will be delighted if my girls get to 31 weeks! Good thing i guess that they plan to start steroids next week or week after with our growth/weight issues.

Big congratulations to yourself and your DH!

xx

CakeForBreakfast · 03/08/2011 10:17

Goodness me what a lot has happened over the last few days!!!

twinnies Well done you for being strong, I guess once a 'plan' is made it is something positive to think forward to. I am wondering what my next growth scan will show up on Friday. You just remember you have two feisty fighters in there...

...speaking of which silver congratulations to you! What high drama. I was reading your post trying to imagine what 3 litres of blood looks like and it freaked me out!

How wonderful to see the little babies in person after so many weeks watching them in black and white on the scans. They are good weights and well done for going to 31+ weeks, I too will be tickled if I can do the same. Please do keep us posted on how you and your family are doing.

Indeed Twinnies, 2 more of us to go - although hopefully not for ages!

xxx

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