Twins with one yolk sac at 9 weeks - mono?

[QueenOfThePumpkins]

Cross posted from the multiples board as it's a bit quiet on there and I didn't get any reponses.

I went for a private scan yesterday as I am an anxious person and another three weeks seemed a long time to wait. We were shocked to find out we've got twins in there! Both measured at 9 weeks as expected and two strong heartbeats were seen.

However, we were told that there was only one yolk sac and they were suspected to be monoamniotic. I (stupidly) started to Google this and it sounds firstly quite unusual and secondly very high risk. I am really worried about our babies either not making it or being born with problems. This is my first pregnancy as well which makes it even more scary! Any words of wisdom? Would love to hear from anyone else who has been through similar. I've been a nervous wreck all day

Monochorionic monoamniotic twins (aka share both a placenta and a sac) are very rare and very high risk, yes. There can be issues with twin to twin transfusion syndrome and also cords being tangled. If they are truly MCMA they are likely to
need delivered quite early. However many twins that look like they're in the same sac are found to have a membrane between them at some point, which makes them MCDA and reduces the risk profile.

You're likely to get quite intensive monitoring and possibly be referred to a specialist centre. Management of MCMA twins has improved from when some of the research out there was done. There are also some FB groups for support (try googling MoMo twins which is what the Americans usually call them). Best of luck.

Suggest you make an urgent appointment with your mw or call your local maternity unit / EPU in the hospital for an urgent referral to a consultant. They will need to check and then monitor you (probably at least once a week) from 12 weeks but you can’t really afford any delays.

Wishing you love and luck! I have no experience of twins but I really hope things progress well for you x

Thank you all for the responses, it means a lot to have someone listen. My DH and Mum are great but I can't face telling anyone else "in real life"

Ironically I was already under the consultant for my anxiety(!!) but my midwife said she'll let them know about this too. She seemed a lot more focused on the twins part though than the mono issue. When I called the ultrasound department they weren't very interested either. I am scared that we will be very much on our own with this as it seems most professionals won't have come across it before. The thought of having to travel miles to a specialist centre makes me feel sick with worry (I can't do big cities at all due to my anxiety). I know I will just have to suck it up.

@CmsrCressidaDuck you sound like you know quite a bit about these pregnancies. Thanks so much for your kind reply. It seems like the concern is there being only one yolk sac and the absence of a membrane. From what I've read, it sounds like when there's only one yolk sac it's almost a given that it will be MCMA. But could they just not have seen one of the yolk sacs? I'm praying they do find the membrane but it sounds like the other key component is pointing against it

Thanks again for reading and replying, and I will have a look at the FB groups too x

I've got mono twins who are now 12. It was a tough ride even though we sailed through with no
scares and delivery at 32 weeks.

12 - 14 weeks is a good time to see membranes. But one yolk sac is an indicator that you do have monoamniotic twins.

There are Facebook groups with people who have more up to date knowledge than me. But if there's anything I can help with.

Hey! Congratulations! Identical twins are the best thing in the whole world😀😀😀 MCMA twina are super rare, it’s more likely that yours are MCDA and that they didn’t see the membrane (mine are MCDA too).

An MCDA pregnancy is still high risk but less so, and I know many many people who have ended up with healthy, happy babies from those pregnancies.

Tips for you: Ask questions and take notes at consultant meetings (I was often in shock and forgot the whole meeting straight after!).

See if there’s a local twin group near you. Other twin parents will be your saviour!

Join (if you want to!!!) “Breastfeeding twins and triplets UK” on Facebook. It’s a lovely closed group full of people who breastfeed their twins. Breastfeeding twins is very much possible (people will tell you it’s not!) and it’s one of the best things I’ve done.

Good luck to you and again, congrats!

My friend had momo twins and it wasn't plain sailing, so expect lots of monitoring but at the stage you are at there's actually nothing they can do, so extra monitoring wouldn't help (The monitoring is to help judge whether to deliver early so from 24/26 weeks). Trying to remember, hers was picked up as query momo at 12 weeks, had a detailed scan at 14 when it was confirmed. She did go to a leading hospital for her care, but cross that bridge when you have to.

Hello, congratulations! I am currently expecting DCDA twins so can’t comment specifically on your situation but just wanted to comment on your feeling of being left alone - you definitely won’t. I was booked in with my midwife at 9 weeks and was then immediately referred to the twin clinic at the hospital, with a consultant specialising in twin pregnancies. So hopefully this should happen with you too! Take a good list of all your questions and concerns (I had many!) but I found this extremely reassuring. Good luck with it all x

I know someone who's recently in this situation and finally at 15 weeks a membrane is now present and doctors are much happier. One twin is still measuring smaller as it has since 9 weeks but it is growing at the same pace as the other so everyone is confident now.

Thank you all, so much.

@itstrue I'm so pleased to hear that things worked out for you, and it gives me some hope. @stucknoue I hope all worked out with your friend's twins in the end too.

Thank you for the tips @HelpIHaveNothingToWear, especially about taking notes. Things do tend to go in one ear and out the other with me, particularly when emotions are high.

Glad to hear that you are being supported well with your twin pregnancy @MrsEG, wishing you lots of luck. It's a shock to hear the word "twins" isn't it!

@20viona that is very reassuring, I don't suppose you know how many yolk sacs there were do you? I can't help but feel pessimistic with there only being one in my case. Fingers crossed for your friend too, even MCDA sounds scary.

@QueenOfThePumpkins I believe there was 2 sacks if I remember correctly. All doctors were very negative at first about the outcome but she kept positive and now all is looking good :). Good luck

Hi everyone, just posting to update as I have finally had my 12 week scan. The twins are doing beautifully and they aren't monoamniotic after all! Even though only one yolk sac was seen at 9 weeks.

The sonographer said that if monoamniocity was suspected at the private scan then they should have gone internal rather than just speculating. She couldn't see the membrane at all until she did that, and then there it was, as clear as day! I hope this reassures anyone in the same boat who comes across this thread later on :)

So pleased for you! Enjoy your pregnancy!

Thank you @Aceinthehole x

Awwww what a relief for you, you must be so happy x