And the Sex Is...

Sorry, you will have to wait with us to find out.

I went in yesterday for my regular two week visit. I saw another female doctor. (They like for you to become familiar with all doctors in the practice in case yours is not available when you deliver.) She asked me if I was having any problems or had any questions. I told her that everything was fine, and that we were just real anxious to know the sex. Her response was, "well, you've got an ultrasound appointment next week, right. Hopefully, you will be able to see then." She joked about how we had two chances to find out, since we only need to see the sex of one to know what they both are. I was disappointed by this response but quickly got over it when I saw that both babies were doing well.

She wheeled in the portable ultrasound machine and said that we would check on the heartbeats. Both babies were moving around and both hearts were beating strongly. It was good, as always, to have the reassurance that both babies are still healthy and doing well. My appointment was over within 15 minutes. I guess these short visits are a good thing. It is nice to have the biweekly reassurance that everything is okay.

...and in MY body news, it appears my belly has finally popped. I am finally looking pregnant and not just fat. Below are pictures of my belly last week (at 15 weeks) and this week (16 weeks). Big difference for just one week!

On the bright(er) side...

We had our first doctor's appointment at Duke Maternal-Fetal Medicine last week on August 12th. Our new doctor is Amy Murtha, and we really like her. We basically just sat and talked with her for a while. We told her who our doctor was in Atlanta and some of the things he told us about our situation. Thankfully, she decided not to drown us in anymore depressing facts and figures, but instead, to come up with a plan to make my pregnancy as successful as possible.

She agreed with most of what the specialist in Atlanta had told us, except for the whole bit about me going into the hospital at the beginning of the third trimester. She said that she was aware that this was normal protocol with doctors in Chapel Hill. However, this was not normally the plan for this practice. Unless I was determined that I needed to be in the hospital or something else happened where it was needed, she did not plan to put me in the hospital for my third trimester. This was the best news I had heard my whole pregnancy!

The plan that Dr. Murtha proposed was for me to come in about every two weeks, to check on the babies and make sure they were okay. She explained that for the next several weeks (up until 20+ weeks), there is really nothing that can be done to fix any problems that may occur. There is no way to predict if, or when, anything would go wrong, so periodic checks are the best we can do. Her plan for the third trimester is for me to come in about three times per week. I know this seems like a lot, but it beats the heck out of laying in the hospital!

Unfortunately, the decision to deliver the babies at 32 weeks seems to always be the plan for momo twins, as the risks of cord accidents outweigh the risks of prematurity at this point. This means that I will not be sharing my birth month with my children (who were originally due February 11), but instead they will be early Christmas gifts, arriving around December 17th.

After we discussed my pregnancy plan, we got to take a look at the babies. As usual, one was kicked back with its feet up (my baby) and the other was moving around like crazy (Ben's baby). Ben was very anxious to find out the sex of the babies, but neither would "give up the goods." One's bottom was too low to be seen and the other had its legs closed shut. The doctor joked that they must be girls tormenting their daddy. Oh well, maybe next Tuesday, when I go to my appointment without Ben, they won't be so shy.

The Honeymoon is Over

Our visit to the specialist gave us a little more insight into what was actually happening in my belly. The doctor explained that the mention of the babies "sharing a sac" referred to the fact that the twins are classified as "monoamniotic twins." The technical term for the situation is "monochrionic and monoamniotic" or "MoMo twins" for short.

He explained that fraternal twins (which I wouldn't have been surprised to have since Ben and I both have a family history of them) are formed when two eggs are both fertilized. Identical twins, on the other hand, happen purely by chance (1 in 250 pregnancies to be exact!) when the fertilized egg splits. If this occurs before the amniotic sac forms, the babies share a placenta but have their own amniotic sac. (This is usually the case.) Unfortunately, my egg waited until about 7-9 days after conception to split, forcing my babies to have to share the same living space.

The doctor explained that our situation is an incredibly high-risk one. The main concern with momo twins is cord entanglement. As a result of cord entanglement, one or both babies' cords can become compressed to the point that they no longer receive any nutrients. These "cord accidents" usually occur gradually. Therefore, I will be very closely monitored throughout my pregnancy through ultrasounds and fetal monitoring.

The plan that he proposed to us was that I would visit the doctor about every two weeks during the second trimester, be admitted to the hospital at the beginning of my third trimester, and deliver the babies via c-section at 32 weeks. When we told him that we were moving to Durham, he let us know that he just moved from Raleigh and studied in Chapel Hill. Therefore, he was able to refer us to Duke Maternal-Fetal Medicine, having personally worked with the director. He suggested that we make an appointment as soon as possible after the move, so that the doctor here could take a look and come up with a care plan.

Needless to say, we left with a much more pesimistic outlook than we had when we arrived. It was kind of a reality check letting us know the honeymoon was over.

Specialist Referral

We went in for another ultrasound the last day in June. It was during this ultrasound that the tech informed us that the babies appeared to be "sharing a sac." At the time we had no idea what that meant except that the twins were identical. Our doctor recommended that I make an appointment with Atlanta Perinatal Consultants, a specialist. She told us we needed a first trimester screening and a twin gestation screening. She recommended that we see the specialist in Atlanta before moving to North Carolina. I scheduled my final OB appointment and the specialist appointment for the last week in July.

the picture is a split image-pic of baby b (with shared yolk sac below head on left) and pic of baby a (with shared yolk sac above head on right)

Twins Confirmed

Due to the crazy blood test results, the doctor scheduled us an ultrasound to "see how many are in there." Ben went with me to the appointment. When images first started appearing on the screen, Ben said, "Well, looks like just one," to which the ultrasound tech replied, "Actually..."

It turns out there is usually an image that looks like an engagement ring. However, our engagement ring had two diamonds instead of one. The tech said that she had never seen such a clear picture of twins that early (I was about 5 1/2 weeks). She called it "textbook".

The doctor confirmed the ultrasound tech's assumption that I was, in fact, carrying twins and that they appeared to be identical. She recommended that I make another appointment in a few weeks to get a better look.

Here we go...

I have so much information to share that I realize that this blog is way overdue. I will try to break everything down into bite-sized entries until we are caught up.

Around the beginning of June, I visited the doctor to confirm that I was, in fact, pregnant. Although fairly unexpected, we were excited about becoming first time parents in a new house, in a new town, with new jobs. On my way out of the doctor's office, I had blood drawn and was on my way.

A few days later, I received a call from the doctor stating that although my urine test had been positive, my blood test was negagtive for the pregnancy hormone, and I may have lost the baby. She requested that I come in for another blood test, which resulted in a normal hormone level for that point in my pregnancy. Just to be sure everything was okay, I went in a few days later to ensure that the hormone was doubling every 48 hours as it should.

My next call from the doctor was both reassuring and surprising. Rather than doubling, my hormone had quadrupled, leading the doctor to joke about the posibility of being pregnant with twins...and thus begins our saga.