IVF Pregnancy Information

1. fati
   
   

   I would love to hear from anyone who has some experience with IUGR and twins.

   I have mono/di ID boys (they share once placenta) and it appears that one of the babies is getting a smaller share of the placenta and may not be growing as well as desired. At 22 weeks, my smaller twin was in the 17th percentile. I go back in at 24 weeks on Thursday for another growth scan. My other twin is growing fairly normally and is in the 33rd percentile. Therefore at this point, there is about a 16-17% discrepancy. They have always had around this amount of discrepancy (since 11 weeks, but they were in higher percentiles in the beginning).

   Note that blood flow and fluid for both babies has been normal (i have been going in every week for a fluid check to monitor for TTTS, unique to ID twins and have gotten dopplers at 20, 22 and 23 weeks and all were normal).

   I am terrified of delivering these boys super early. Obviously they will be preemies, but I am just hoping to keep them in as long as possible. My doctor is concerned about how small baby B is.

3. annoula
   
   

   I did with my fraternal twin boys. They were born at 32w and my baby a was 4lbs 9oz and baby b was only 3lbs 4oz. The NICU immediately said baby b suffered from IUGR (the size difference happened much later in my pregnancy though - I think they started picking it up at 27ish weeks) . Baby b definitely struggled a bit more in the NICU but ended up coming home only one day after his brother. He was the one they always told us we would have to watch for developmental delays, etc. At almost 10mo he is the one hitting milestones at his actual age vs adjusted age like his brother. He is now bigger by over 3lbs and is just doing amazingly well. Obviously it is something to be watched, but it doesn't necessarily mean there will be any major issues resulting from it.

   Good luck with your twin pregnancy. I know how scared I was the whole time with mine.

4. Ameur
   
   

   I had b/g twins in 2001 at 35w, and growth discordancy was noted from first u/s at 6w, but really at 24w when we started BPP's and NST's 3x/wk because of DD's size. She was growing, but at a much slower rate than DS. She had low fluid and I had serious cervix issues so I was admitted at 29w and was on a monitor 24/7. She passed all BPP's each time and at 34w peri said he wanted to deliver the following week b/c my kidneys were shutting down. BPP at that point showed DD at 17th percentile, DS at 90th percentile. When they were born, DD weighed 3lbs9oz, DS weighed 6lbs8oz.

   Neither needed a NICU stay; both were treated for jaundice, and DD had an IV to regulate her sugars plus an ng tube so she wouldn't lose any more weight. I gave birth on a Monday, brought DS home with me on Friday, and picked DD up on Saturday.

   What matters is gestational age. DD was the size of a 30-weeker, but born at 35w. They did an amnio on the day before delivery to check for lung maturity (on DS, since boys' lungs mature more slowly) and we got the green light to deliver the next day. And yes, DD's lungs were mature at birth. Your baby will be monitored closely for fluid, movement, practice breathing, growth. If he continues to thrive in the womb and pass BPP's it will be safe to continue the pregnancy. It's a scary thing, I know, believe me. When I was admitted at 29w because I had zero cervical length left, they told me I would most likely deliver within 24 hours and the neonatologist came in to talk to us about \"mortality vs. morbidity.\" DD wasn't even 1lb at that point, and they gave her a 50/50 chance of survival. I told them there was NO way I was delivering that soon and I stayed there for 45 days until I delivered. I had been drinking 40g protein shakes from 11 weeks on and continued to do so in the hospital. I know all about the terrifying feeling. I really basically spent my entire pregnancy paralyzed with fear. But doing little things which were in my control helped me feel better. And above all, you know your body best, so don't EVER let any medical professional dismiss your concerns. When I was 24 weeks I was seeing a \"high risk\" OB, and I kept telling her I wasn't feeling Baby B moving as much as Baby A. She said, \"Erin, I don't know what to tell you. There's nothing more I can do for you. If I delivered your babies now they'd die.\" That was the last time I saw her. Two days later I was in my peri's office scheduling BPP's and NST's 3x/wk because of the growth discordancy, measured by the u/s they did THAT DAY...I didn't have a single u/s at the ob's office.

   Good luck to you! BTW, my twins are 7 y/o today and she is an inch taller and weighs 11lbs more than he does.

   Erin
   Mikkel and Saoirse, 12.17.01
   Ian, 3.6.06

5. Olgag78
   
   

   I delivered b/b twins at 36w, two weeks earlier than scheduled C because Twin A was no longer growing normally. I went in for a routine u/s and the peri sent me upstairs to L&D and I delivered 4 hours later. My boys were 4.14 and 6.1 at birth- now, at 11.5 weeks, they are 9lbs and 13lbs! My little guy is doing well and did not spend time in the NICU while the big guy did for some breathing issues after birth. Both babies are healthy and happy now and maybe Twin B will always just be the bigger guy. Good luck to you!

6. fati
   
   

   Thanks ladies- I really appreciate you sharing your stories.

   I have been doing modified bedrest and drinking 3 ensure plus drinks per day since my last ultrasound.

   Yesterday, I went in at 23w6d, and shockingly my smaller baby B was 1lb4oz (up from only 12.5oz 2 weeks ago) and my bigger baby was already 1lb7oz (up from around 15oz 2 weeks ago)! So they popped up to the 28th and 50th percentile...and they are only 15% discrepant in weight. I couldn't hardly believe it!

   I definitely don't feel that I'm totally out of the woods but I really feel that they are going to be ok- and that i REALLY am going to have two babies! My next growth check is at 26 weeks (25w6d to be exact). Crossing fingers for another good result!

7. aref
   
   

   I had b/g twins at 38w3d. Our son was 7lbs. 11 ounces and our daughter was 4lbs. 11 ounces. The discordance was discovered at my 19 week scan and was consistently in the 30% range.

   Both babies came home from the hospital with us.

   At 10 weeks, he was 12lbs. 4 ounces and she was 8lbs. 3 ounces.

   I do not see a day that she will ever catch up to him in size...he is a BIG boy. They are 4 months old now and doing well.

   Good luck!

8. fati
   
   

   Hi ladies- well I am still trucking along here...28 weeks today and my ultrasound yesterday (27w6d) showed baby A at 2lb6oz (40th percentile) and baby B at only 1lb14 (16th percentile). Both babies had good fluid and blood flow. My doc is starting me on 2x weekly NSTs (standard for ID twin pregnancies she said) and another growth scan in 2 weeks. We are hoping to at least make it to 32 weeks. I am just hoping I can get baby b above 3lbs before he will be delivered.

   This is the worst! I wish I could just fast foward 4-6 weeks.

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