Pretty in Pink Posted February 15, 2012 Share Posted February 15, 2012 (edited) ETA: Nevermind. The babies are MoMo -- sharing both an amniotic sac and one placenta. That's why they are taking them so early. A relative is expecting twins and says she is being sectioned @ 32 weeks, per doctor's orders, because "... any further and the risk of cord engagement and compression get even higher, its crazy but they say the percentage of fetal death increases after 32 weeks so we definitely want them to be safe!" I've never heard that (then again, I've never had twins). Is this SOP? Maternal history is obesity, pre-eclampsia, and 2 c-sections. Edited February 15, 2012 by Pretty in Pink Quote Link to comment Share on other sites More sharing options...
frugalmama Posted February 15, 2012 Share Posted February 15, 2012 Never heard that either - Most twin births I know of go to 36 weeks, some even 38. Quote Link to comment Share on other sites More sharing options...
LittleIzumi Posted February 15, 2012 Share Posted February 15, 2012 It's not standard for twins, but it might have something to do with her maternal history. I know several sets of twins carried easily to over 37 weeks (one set to almost 40 weeks). Quote Link to comment Share on other sites More sharing options...
laundrycrisis Posted February 15, 2012 Share Posted February 15, 2012 Are they "momo" twins ? That is very high risk and they usually want to deliver them pretty early. http://multiples.about.com/od/medicalissues/a/MoMoTwins.htm Quote Link to comment Share on other sites More sharing options...
sandellie4 Posted February 15, 2012 Share Posted February 15, 2012 I don't think it's standard either. If I didn't know the doctor pretty well and trust him or her, I'd be getting a second opinion. That's awfully early, and a lot of babies born that early have serious complications. Even the ones who don't have serious medical complications have special educational needs/learning disabilities. There may be no choice given the mother's history, but I'd want to make absolutely sure it was necessary. Sandy Quote Link to comment Share on other sites More sharing options...
Danestress Posted February 15, 2012 Share Posted February 15, 2012 She is probably choosing not to share the full story. Quote Link to comment Share on other sites More sharing options...
AuntieM Posted February 15, 2012 Share Posted February 15, 2012 Given the maternal history, I could imagine the doctor feeling that his liability for his primary patient. There's such great technology these days for taking care of preemies, maybe he feels 32 weeks is safe? Just guessing. I do remember my OB telling me that multiples were considered full term at 37 weeks. Are the babies identical twins? Sharing the same birth sack does increase the potential for complications. I wonder, though, why he wouldn't put her on bedrest first, or hospitalized supervision? Quote Link to comment Share on other sites More sharing options...
TheTwinsMom1 Posted February 15, 2012 Share Posted February 15, 2012 If they are talking about cord entanglement they are probably Mo-Mo twins like somebody else said. With that tyep they do take early due to potential problems with the cords. Quote Link to comment Share on other sites More sharing options...
Pretty in Pink Posted February 15, 2012 Author Share Posted February 15, 2012 (edited) She is probably choosing not to share the full story. She is posting this stuff on FB for everyone to see. The twins are identical. I asked her if they are MoMo but she hasn't responded yet. AuntieM, I too wonder about close supervision rather than taking them so early. She is still in her first trimester -- seems early to be planning a delivery like that but, like I said, I don't have twins. ETA: They are MoMo. That makes sense. Edited February 15, 2012 by Pretty in Pink Quote Link to comment Share on other sites More sharing options...
Veritaserum Posted February 15, 2012 Share Posted February 15, 2012 Yeah, MoMo is a special case. I imagine they will be very closely monitored and be given medications prior to the anticipated birth date to help with lung maturity. 32 weeks is still really early, so I hope all goes well for them! Quote Link to comment Share on other sites More sharing options...
ktgrok Posted February 15, 2012 Share Posted February 15, 2012 Never heard of that. I know there is a book by someone named Dr. Luke that is the gold standard for getting healthy twins. I'd look it up in that. I know the two women that I know that had twins went full term. 38 weeks for one and 40 for the other. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted February 15, 2012 Share Posted February 15, 2012 ah, ok...still advise the book though. It would be a great gift. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted February 15, 2012 Share Posted February 15, 2012 Is this SOP? Maternal history is obesity, pre-eclampsia, and 2 c-sections. :iagree: with PP's. Not it is not normal - but given her history - especially the two previous sections and twins this time, it's understandable with the increase risk of a rupture because isit far more stretched. with the obestity, it also puts her at greater risk of gestational diabeties and macrosomic babies (even in twins) which is more physically stressful on the uterus. I only had a VBAC last time because I had a history of successful VBAC's - but the hospital I delivered at was basically shutting them down becuase of the risk of ruptures going unnoticed. My dr actually had to stay ON the hosptial campus while I was laboring wth pitocin (srom and no regular contraction pattern) - he had to cancel his afternoon clinic until I delivered. For the most part - it is a cya treatment plan. blame malpractice insurance rules protecting themselves from tort lawyers. Quote Link to comment Share on other sites More sharing options...
Mommy22alyns Posted February 15, 2012 Share Posted February 15, 2012 (edited) Are they perhaps mono-mono twins? ETA: Okay, saw the update. That's what I thought. Someone on another board I visit had mono-mono girls and she was hospitalized and they were taken fairly early. Edited February 15, 2012 by Mommy22alyns Quote Link to comment Share on other sites More sharing options...
laundrycrisis Posted February 15, 2012 Share Posted February 15, 2012 ETA: They are MoMo. That makes sense. MoMo is a very special case. The twins are in the same amniotic sac. They share one placenta but each have their own cord. There is nothing between them to stop them from tangling up in each others' cords, so the risk of cord compression is much higher than normal. That is why they are delivered early. The risks of remaining in utero are higher than the risks associated with early delivery. Delivery this early is normal for MoMo twins. Quote Link to comment Share on other sites More sharing options...
JFSinIL Posted February 15, 2012 Share Posted February 15, 2012 I had post-term (nine days late )twins and never heard of them being taken early unless the babies were in distress. Most of the moms in my Mothers of Twin club here went 34 weeks or more. The silly doctor should monitor the pregnancy and NOT take the babies out that early unless there is a **** good reason. More likely the babies will have problems from being premature than get a cord tangled up etc.!! She needs a second opinion!!!!! (I switched O.B.s halfway through my twin pregnancy - she should contact the moms in the nearest Mothers of Twins or Mothers of Multiples group and get not only their opinion, but also the word on that doctor!!!!!) Quote Link to comment Share on other sites More sharing options...
JFSinIL Posted February 15, 2012 Share Posted February 15, 2012 MoMo is a very special case. The twins are in the same amniotic sac. They share one placenta but each have their own cord. There is nothing between them to stop them from tangling up in each others' cords, so the risk of cord compression is much higher than normal. That is why they are delivered early. The risks of remaining in utero are higher than the risks associated with early delivery. Delivery this early is normal for MoMo twins. Ah , now it makes more sense. Never mind my rant. Quote Link to comment Share on other sites More sharing options...
AdventureMoms Posted February 15, 2012 Share Posted February 15, 2012 Certainly not standard for all twins, but for mono-mono with two prior sections...it certainly doesn't shock me. I'm in a twin group (70+ moms of multiples) and I've never heard of mono-mono twins going past 34 weeks. My understanding is that mono-mono twin pregnancy is actually riskier than di-di-di triplet pregnancy. Di-di twins routinely go to 38 weeks (or longer). Our twins (di-di) were born at 35wks because baby A's water broke, but the goal was at least 36wks and the doctor was willing to go a full 40 weeks with close monitoring and assuming everything looked ok. Quote Link to comment Share on other sites More sharing options...
weat4 Posted February 15, 2012 Share Posted February 15, 2012 I had triplets at 35 weeks which was considered "term" by my specialist ~ anything after that and things could go down hill quickly. My closest friend had twins at 39.5 weeks ~ not sectioned. Are they identical? There are higher risks for identicals sharing a sac without a dividing membrane, but 32 seems early. The best to her! Quote Link to comment Share on other sites More sharing options...
Paige Posted February 15, 2012 Share Posted February 15, 2012 Another consideration is that there is a high risk for twin to twin transfusion with mo-mo and di-mo twins. If the twins' growth patterns are unequal, then they will be delivered much earlier than usual. Di-di twins routinely go full term and they are the most common because it includes all fraternal and some identical twins. I've never heard of mo-mo twins going past 32 weeks. It is a very high risk pregnancy but also the most uncommon. The people I've known with mo-mo twins have delivered them at the first sign of distress or 32 weeks- whichever is earlier. I think they are routinely given steroids to help the lungs too. Quote Link to comment Share on other sites More sharing options...
Bluegoat Posted February 15, 2012 Share Posted February 15, 2012 but the hospital I delivered at was basically shutting them down becuase of the risk of ruptures going unnoticed. For the most part - it is a cya treatment plan. blame malpractice insurance rules protecting themselves from tort lawyers. The risk of an unnoticed rupture is not really that great though. It's mostly about hospitals bowing to pressure from insurance companies. Quote Link to comment Share on other sites More sharing options...
The Girls' Mom Posted February 15, 2012 Share Posted February 15, 2012 My twins were Mo-Di and I was monitored EXTREMELY closely. I had them at 34 weeks (natural labor), but they told me early on that if there was even a hint of trouble they would take them earlier. If they had been mo-mo my chances of early delivery went up even more. Thankfully there was no transfusion. Quote Link to comment Share on other sites More sharing options...
eight_gregorys Posted February 15, 2012 Share Posted February 15, 2012 I have twins that shared a placenta and sac. I went into labor at 33 weeks, but there was never any mention of taking the boys early. I was monitored with stress tests 3 times a week and ultrasounds once a week after 28 weeks. I had a history of preeclampsia, too (3 out of 5 pregnancies). I'm not sure if its standard or not to take twins at 32 weeks. Quote Link to comment Share on other sites More sharing options...
melmichigan Posted February 15, 2012 Share Posted February 15, 2012 Around here they would be lucky they are talking waiting until 32 weeks with mo-mo twins, it more usual to see 29 weeks with the high risk OB's here, and your talking 24 hour in hospital monitoring before that. Quote Link to comment Share on other sites More sharing options...
chepyl Posted February 15, 2012 Share Posted February 15, 2012 I don't know about the different types of twins, but my friend was induced at 40 weeks because she never went into labor. She was on bedrest for 10 days. She went in 2-3 times a week for stress tests and had an ultrasound once a mobty and then weekly I think. Even if this is standard for most twins of this type, I would get a second opinion. It is good to get a second opinion and check out your doctors as much as you can. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted February 15, 2012 Share Posted February 15, 2012 MoMo is a very special case. The twins are in the same amniotic sac. They share one placenta but each have their own cord. There is nothing between them to stop them from tangling up in each others' cords, so the risk of cord compression is much higher than normal. That is why they are delivered early. The risks of remaining in utero are higher than the risks associated with early delivery. Delivery this early is normal for MoMo twins. My sister had a singleton that was taken via section at 30 weeks. they didn't know what was going on - other than my sister insisting something was wrong, the baby wasn't moving, and tests were backing her up. baby had tied her umbilical cord in TWO true knots and was basically starving herself. (she was delivered at a major teaching hospital because of gestation, the ob in charge had never seen that before - though he'd heard of it.) all by her lonesome. she scooted around her isolet so much, her feet were raw. you can imagine the risks if there are two babies to tangle up each other. It is serious -I don't know what type of twins my friend had - but the second twin's cord was around the first twin's shoulder when he was delivered. not pretty. second twin was born dead from compression of his cord. Quote Link to comment Share on other sites More sharing options...
AdventureMoms Posted February 15, 2012 Share Posted February 15, 2012 My sister had a singleton that was taken via section at 30 weeks. they didn't know what was going on - other than my sister insisting something was wrong, the baby wasn't moving, and tests were backing her up. baby had tied her umbilical cord in TWO true knots and was basically starving herself. (she was delivered at a major teaching hospital because of gestation, the ob in charge had never seen that before - though he'd heard of it.) all by her lonesome. she scooted around her isolet so much, her feet were raw. you can imagine the risks if there are two babies to tangle up each other. It is serious -I don't know what type of twins my friend had - but the second twin's cord was around the first twin's shoulder when he was delivered. not pretty. second twin was born dead from compression of his cord. If their cords were tangled around each other they were mono-mono twins. This is the rarest type of twins and the most dangerous type of twin pregnancy for just that reason. Only mono-mono twins share an amniotic sac. Mono-di and di-di twins have separate sacs and cannot get tangled around each other. Mono-di twins share a placenta can still have issues with transfusion (one baby drawing nutrients and oxygyn from the other), so they are higher risk than di-di twins (who don't share either the placenta or the sac). Di-di twins are by far the most common type (all fraternal twins and a few identical twins are di-di) and they are not terribly high risk for most women. Mono-mono is a very different situation though. Quote Link to comment Share on other sites More sharing options...
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