Monochorionic Diamniotic Twins

I have had many of you ask me questions about the twins….the reason for the early delivery, how I know if they are identical or not and the list could go on and on. I’m going to try and do a little “informative” post about the type of twins we are having and why we are more of a “high risk” than a twin pregnancy with fraternal twins OR twins with separate placentas.

What exactly are Monochorionic Diamniotic twins?
They are monozygotic (identical) twins that share the same placenta. (

twins
{image source}

The low down on identical twins:
They are originally from one embryo that split into two. If the embryo splits very early on, then the twins are identical but have separate placentas and amniotic sacs (dichorionin, diamniotic). If the embryo splits a little later, the result is identical twins that share a placenta (monochorionic) but are in separate sacs (diamniotic). Very late splitting of the embryo is rare but can result in conjoined (siamese) twins, or two babies that have the same placenta and are in the same sac (monochorionic, monoamniotic). This type of twins is at highest risk of various complications of pregnancy.

twins{image source}

Why are they suggesting a cesarean section for your delivery even though you delivered both boys vaginally?
Because the girls share a placenta they are at risk of developing TTTS (twin-to-twin-transfusion-syndrom). They have both, thankfully, gotten past the “danger” stage and are both growing well, but with a shared placenta the girls will run the risk of developing TTTS even through a vaginal delivery. With the delivery through c-section this takes that risk away completely.

Why do they suggest taking the girls out at 36-37 weeks? Don’t they want them to gain as much weight as possible?
They suggest 36-37 weeks because of the TTTS. Once they are “healthy” enough to come out, they suggest taking them so they don’t ever have the risk of developing TTTS since it can be fatal. Yes, they do want them to gain weight, but having them healthy & a small weight is better than keeping them in longer than necessary and running the risk of developing TTTS.

What exactly IS TTTS (twin-to-twin-transfusion-syndrom)?
It is a complication of disproportionate blood supply, resulting in high morbidity and mortality. It can affect monochorionic multiples, that is, multiple pregnancies where two or more fetuses share a chorion and hence a single placenta. Severe TTTS has a 60–100% mortality rate. (wikipedia)

Currently the girls are showing no signs of TTTS and are both growing beautifully. They are still smaller than normal, but growing well. During our scan last week they also showed that each twin has the exact same amount of fluid in their sacs, which is also a huge plus. I have to get an ultrasound every other week to check on their growth, amnionic fluid levels & make sure the membrane is still looking well. Our last scan, the doctor told me that their membrane was “absolutely beautiful”. It just looked like a squiggly little line to me ;) .

When are you due?
Oh goodness. I get this question asked all the time, and if I were a ‘normal’ twin pregnancy it would be so simple to answer. Here’s the gist of it:
I am technically due: October 17, 2012
Average time for twins to arrive is 35 wks which would make me due: September 11, 2012
Delivery of MoDi (MCDA) twins here in the UK is 36-37 wks which is: September 19-25, 2012
SO…..I tell people early/mid September. This way I’m covered from about 33 weeks. (which is very likely I’d deliver closer to)

I think that’s all the information I’ll load you with today. I hope I’ve helped you better understand this whole “twin” thing. ha ha. Oh, some of you have asked about a registry for the girls and what we still need for them. We have our registry on Amazon since it’s easiest to ship to us through them. I’ll put the link below. Really, we just need clothes from newborn and up & whatever is on our registry…..oh and lots of newborn diapers since I won’t be cloth diapering in the beginning! Thanks so much you guys! You’re the best.

Baby Registry for the TWINS

twins

xoxo

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Comments

  1. So fascinating! And I’m SO glad to hear that they are growing well and at the same rate. My twins are fraternal so we didn’t have these extra worries, but it sounds like everything is going smoothly. :) Strangely enough one of my boys was about 2 weeks behind the other in growth for the entire pregnancy so we wonder if they weren’t conceived on the same day, but we’ll never know.
    mandy @ this girl’s life recently posted..{playing dress up}My Profile

  2. Very well explained! Now here’s another question….why not cloth diaper in the beginning?

    Oh and you’ve got a package being mailed today :)

  3. It’s so fun that you used the pictures so that we could understand! I’m sure you have had to explain this over and over and over again. So now you can just forward others to this awesome post! xoxo
    Beth @ Through the Eyes of the Mrs. recently posted..Blog Crushes with Absolute MommyMy Profile

  4. so neat! Thank you for taking time to help educate us all! :)
    Tara recently posted..My thoughts on breastfeedingMy Profile

  5. so neat! Thank you for taking time to help educate us all! :)
    Tara recently posted..My thoughts on breastfeedingMy Profile

  6. I’m loving ready about your pregnancy! I am due October 21st, 2012, so we are on the same track, only I only have one blessing instead of two!

  7. I’m loving ready about your pregnancy! I am due October 21st, 2012, so we are on the same track, only I only have one blessing instead of two!

  8. What a wonderful blessing! God is SO good. Looks like our special package/packages will be arriving around the same time…
    I can’t wait! :)
    Jenn recently posted..Wordless Wednesday…My Profile

  9. Well, I learned a lot today. Sounds like you guys have done your research and have a good handle on what to expect during the delivery process. :) Know that we’re praying for you guys every step of the way!

  10. Hi! I’m so glad I found your blog today!! I’m also due with twins!! I look forward to going back and reading more!!
    Mandy recently posted..What I’m Loving Wednesday!My Profile

  11. Thanks for explaining. I am crossing everything that everything continues to do well with the girls.

    {huge hugs}
    Niki recently posted..Thursday greetingsMy Profile

  12. Hi!

    Very well explained! I am currently 36 weeks pregnant with MCDA boys!  We have been watched very closely for TTTS too but they have both been growing well with no problems. They have both been head down for 10 weeks so our hospital is preferring a vaginal delivery for me and I will be induced  a week today! 

    Wishing you all the best – not long now! :-) ) x

  13. Hello my name is Michelle….I just found out that I’m having twins and they are monochromic diamniotic identical twins. I’m only 7 weeks and I am very nervous and scared. After reading your selection you have eased some of my fears and I thank you so much for that. I have a long road ahead of me:(

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