Mo-DI, Baby!
posted 09.13.2004 by Kristen

After the initial twinshock wore off (well, somewhat, at least -– I’m not sure it’ll ever wear off completely), we had our first official appointment at our OB’s office, where the midwife nonchalantly told us they thought the twins were monoamniotic.

She also told us that it was normal protocol for their twin patients to be advised to take it very easy, to be put on “house arrest” at 26-28 weeks, to be referred to a perinatologist who’d work in consultation with my regular OB, etc. But honestly, I didn’t really hear much past monoamniotic.

The reason this freaked me out so much is because monoamniotic is the absolute highest-risk twin configuration. What this means is that not only are they sharing the same placenta (monochorionic), they are also sharing one amniotic sac. This is very dangerous because they can get caught up in each other's umbilical cords, and there's nothing you can do about it without delivering the babies. There is an extremely high fatality rate with monochorionic-monoamniotic (a.k.a. "mo-mo") twins. The most successful treatment is to admit women with mo-mo pregnancies to the hospital at 24-26 weeks (the point of viability) and put the babies on 24/7 fetal monitoring. At the first sign of distress, the babies can be delivered. But prior to viability, there's absolutely nothing that can be done.

But while I was freaked out, I was also feeling hopeful. Based on my research, 8 weeks (when we had our first ultrasound) is too early to be able to see the dividing amniotic membrane, and many women who have ultrasounds that early are misdiagnosed simply because the membrane isn't visible yet. Apparently 10-13 weeks is the best time to see the membrane.

So today, at 11 weeks, 4 days we went for our first visit to the perinatologist for a high-resolution ultrasound to see whether he could find a dividing membrane or not. As soon as the peri asked, "What made them think they was no membrane?" I knew we were in the clear. And yep, there was a membrane, so we're monochorionic-DIamniotic! After that we could relax and enjoy seeing the babies, who now actually look like babies rather than jellybeans!

It was really amazing just how much detail we could see. I mean, they're less than 12 weeks! We could see the spines, all four chambers of their hearts beating away, their brains. Amazing. Just amazing.