Monoamniotic Twins - help

Hi All,

After my scan today my OB seems to think I am carrying monoamniotic twins. I am going for a second opinion scan tomorrow on more advanced equipment, but my OB seemed confident he was correct.

Without trying to scare us he mentioned this kind of identical twins are higher risk than any other twins and that this pregnancy will be monitored very closely with scans weekly and bed rest towards the end likely. He also indicated that making it to 34 weeks would be a big achievement as these twins tend to need to come early.

Has anyone here had monoamniotic twins or know anYthing about them? Any advice, information etc would be deeply appreciated.

X

A good friend of mine had momo (often abbreviated to that) twins in 2010. She had weekly scans with a specialist from about 28 weeks on (every 4 weeks before then). She didn't have any bed rest or hospitalization. I think that bed rest depends on the opinion of your OB.

She made it to 34 weeks when they were delivered by c-section. They were both over 2kg at birth, breathed on their own and had just under 3 weeks in hospital. She was given steriod shots before they were delivered.

Australian Multiple Birth Association
The Australian Twin Registry
Dear thirdtimelucky

Congratulations on your twins! I am a diamniotic twin (born vaginally at 39 weeks, AND breastfeed for 14 mths). So can't give a personal story on monamniotic twinning, but I can help you get started on some research by pointing you in the direction of some decent resources. Ultimately you will make a decision that YOU are most comfortable with. If you do not feel comfortable or informed from your OB, seek further opinions. The most important thing is informed decisions.

From what I understand, the main issue with shared amnions is cord entanglement. I gather that if both babies are head down, vaginal delivery is possible. Chances are if you want a vaginal birth you may need to 'fight' for it. (many twinning mums find they are encouraged to have preterm csections, no matter what type of twins). Ask what they want to watch for on the scans. It might be cords, growth, positions. This information will help you decide what is best for you.

Most of all though - enjoy your pregnancy,relax and rest (as much as you can), perhaps even consider talking to a doula (ortwo, find one you click with). A doula will help you navigate the information and interpret it, she won't make decisions for you or advise you, but she will support you and make sure you are able to make an informed decision. very empowering. Even if you don't want her at the birth, you can still ask for pregnancy support.

The Australian Twin Registry compiles data about twins. This site has some good links for support groups and play groups, and some resources.
Facts and figures about twins
Resources for twins (for a free twin pregnancy booklet)

Article about monoamniotic pregnancy.
Perinatal Outcome of Monoamniotic Twin Pregnancies : Obstetrics & Gynecology

two article abstracts about vaginal delivery of monoanmiotic twins
Monoamniotic Twins: A Retrospective Controlled Study : Obstetrics & Gynecology
Monoamniotic twin pregnanci... [Eur J Obstet Gynecol Reprod Biol. 1996] - PubMed - NCBI


All the best - I hope you share your journey with us. xoxoxox

Catherine

Put simply they are higher risk because they share the same sack. so there is nothing inbetween them. they are physically in the same space so can move and play with eachother, which whilst is very cute, can lead to them getting in a few tangles with their own cords, and eachothers. Another issue is then they would share a placenta, and as a result twin to twin transfussion is a high risk, where the cord flows between the twins are different and one ends up with too much and the other not enough.

Just means a bit more monitoring to keep an eye that your little ones are growing adequately and not getting up to too much mischief =)

Just let me know if there is anything you need to know =)

and YAY!!! for babies!!!!!

Hi thirdtimelucky, I have got triplets and apparently 2 of my DDs are identical. I was flown to Brisbane at 16 weeks and they determined after 2 hours of U/S and 3 sonographers they found that my girls shared a placenta but were in separate sacks. I was told I would be looking to get to 30 weeks but managed to hold to 33+6 before pre eclampsia kicked in. Funnily enough while being prepped for my emergency C/S I started to go into spontaneous labour. Honestly it's just more frequent scans and OB visits. I asked them for steroids at 28 weeks as I was terrified they would be sick prems but thankfully my girls came home at 37 weeks corrected.

My twins shared a placenta but had seperate sacs (I've forgotten the terminology now!). The link that Catherine has posted to the Australian Multiple Birth Association (AMBA) is a great one. They have a fantastic forum (not that BB isn't great, but you may find more people on their with similar stories to yours). You need to post at least 5 times I think to gain access to the whole forum.

In terms of sharing a placenta, there is the higher risk of TTTS, and sharing a sac would mean great risk of entaglement. Your doctor sounds fantastic though! Mine talked in terms of 'if' the twins survived, so it was pretty stressful and negative seeing him. As well as more frequent scans, I also had weekly monitoring at the hospital of the girls heartbeats from around 30 weeks - a very boring, frustrating process with twins "Yes, we are monitoring 2 heartbeats". Half an hour later "Opps! That's the same twin on both monitors".I did not have any bed rest or anything. At about 33 weeks, Milla showed signs of slowing in growth and at 35 weeks, they steped the monitoring up to 3 times a week - and I went into labour at 35wks and 2 days :). Both twins were head down so they arrived naturally. They were little when they were born (around 4 pounds each) and spent about 3 weeks in the special care nursery until they put on a bit of weight.

Fingers crossed you get some more answers at you scan. It is a pretty stressful thing to be pregnant with multiples. I felt like it was so out of my hands, that I tended to feel a little helpless at times. Big hugs to you xx

Hi All,

Thank you so much for your supportive and helpful responses! And apologies for not having responded sooner - we have been away since the morning after my formal scan.

Amazingly and thankfully - the expert ultrasound tech managed to find a membrane between the twins so they are not mono after all, however they are still sharing a placenta and are identical.

So far I am feeling pretty good - but I am still moderately freaking out about how we will cope with two babies andi guess a total of four babies, when we were planning for three.

We do feel really blessed and I guess the fear is a normal part of the process.

Thanks again everyone for your support xx

Yay! I've been thinking of you and hoping it all went well. That is good news. My girlies are identical and it is lovely - scarey at first when you think 'I am not sure which baby is which'. We kept their hospital bands on until they outgrew them, and then tied a ribbon around Claudia's wrist. A quick check of who was wearing the ribbon always reassured us on which baby we were holding :) We did that until they were about 2 months old - which sounds terrible now lol - but one day it just clicked as to who was who.

Plus - already having kids - you know how babies work. It is double the workload but it is also double the squishy baby cuddles!

Hi there. Good to hear that the twins aren't monoamniotic however a friend of mine had monoamniotic twins 5 or so years back. She had a scheduled c-section at 32 weeks and the girls were just fine.