Thursday, 12 January 2017

Monochorionic Monoamniotic twins - Identical twins - Truly blessed

My twin girls, who are now 5 years old are having one or two issues at school currently, mainly due to teachers appearing to subconsciously be seeing them as one person rather than two.
We have a meeting with school tomorrow, which I'm sure will alleviate the issue, at least for now and will provide lots of discussion for another blog post.

Whilst worrying about the girls at school, I took some time out to remember their birth and the fact that they are here at all is pretty miraculous! The girls are Monochorionic-monoamniotic twins or Momo twins for short. Briefly this means that the twins not only shared a placenta as all identical twins do, they also shared the same amniotic sac. This is very rare in twin pregnancies and it is estimated that it occurs 1 in 60,000 twin pregnancies. Unfortunately momo twins are at a greater risk during pregnancy due to their close proximity to each other, causing cord entanglement. When googling the prognosis of momo twins I was shocked to find that the survival rate for momo twins is 50%. It is not known why momo twins occur, but it seems to depend on when the fertilized egg splits into two. Research also shows that it may also be due to the number of yolk sacs present in the pregnancy.

So, I am truly blessed to have healthy twin daughters when the odds were stacked against them.
Everyone's pregnancy is different. At seven weeks pregnant I suffered a couple of episodes of bleeding so I had an early scan. The scan showed a healthy pregnancy with one heartbeat happily beating away. It was then decided that I wouldn't need a 12 week scan, as I'd already had one at seven weeks. Roll on the 20 week scan! At 20 weeks I was expecting the usual dating scan and was considering asking the sex of the baby. The sonographer then asked if we had twins in the family? To which I replied, No. Well, you have now was her reply! She then went on to take measurements and told us we were expecting girls. My husband and I were happy, if a little shell-shocked. The sonographer then said that she couldn't see a membrane between the babies, so we were sent to Leeds General Infirmary for a more detailed scan. The consultant at the scan, couldn't see for definite if there was a membrane either and she said they would have been able to see more clearly at the 12 week scan. She felt that she could see a hairline separation and the twins were growing normally with no sign of twin to twin transfusion, they took the decision to treat the pregnancy as if they were in separate amniotic sacs.

If it had been confirmed that the twins were momo they would have been delivered by 32 weeks as the risk of entanglement becomes greater the larger the twins grow, due to space becoming limited.
I had a planned c section at 36 weeks, where it was confirmed that they were monochorionic-monoamniotic twins. The cords were plaited and tangled, however luckily the cords were thick and healthy, so no compression occurred. Wow! we were so lucky. my husband and I both feel there were angels watching over that pregnancy. The outcome could have been horrendous and delivering at 32 weeks would have meant that the babies would have needed specialist care, potentially at separate hospitals. So we had no intervention and the girls were delivered successfully.

I hope that other parents going through this can see that there is hope when given a poor prognosis. I realise that all pregnancies are different, but I know when I was reading up on the condition, I would have liked to have read some positive stories and outcomes. I am very happy to answer any questions if I can be of help.

So, when I collect my girls from school today, I will give them an extra hug and count my blessings.

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