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Two Babies, One Sac, More Risks
The Triumphs of Monoamniotic Twins
By Teri Brown
, that includes several sections of information and a bulletin board system where members can post for individual support. The Web site is dedicated to anyone who is encountering the stress of expecting monoamniotic twins or who endured the unique problems and endless worry of monoamniotic twins to have healthy babies.
Because of the information shared on the Web site, it is now known that a significant number of parents who are diagnosed before 12 weeks, by their regular obstetrician or by using a regular resolution ultrasound, are later found to not be monoamniotic after all. Usually, it's the first appointment with the specialist with an ultrasound on a high-resolution machine that clearly shows a thin membrane between the babies.
"The first part of the pregnancy was managed by our local obstetrician with monthly visits to the specialist for a high-resolution ultrasound," says Giacobe. "At 24 weeks, we had a round of steroid shots, just in case. At 26 weeks, my wife received twice-weekly non-stress tests (NSTs) in our local obstetrician's office. And at 28 weeks, my wife moved to live nearby the 'big hospital' where the specialist was and that had a Level III NICU. At that point, she received once-daily NSTs, weekly ultrasounds and frequent biophysical profiles. Our plan was to deliver by C-section scheduled at 34 weeks."
On Saturday, December 30, 2000, the daily NST strip showed that one of the Giacobe's twins wasn't doing well. The doctor scheduled an emergency C-section for as soon as possible that day. Both girls were small but relatively healthy.
"We were very lucky to get our girls out alive," says Giacobe. "Our delivery was on a Saturday of a three-day weekend. We are convinced that if we did not do the daily NSTs, our girls would have died before the next regular business day. Daily NSTs saved our daughter's lives."
This type of aggressive management is bringing an increase in happy conclusions to parents pregnant with monoamniotic twins. Earlier diagnoses, more aggressive management and advanced medical technology are making a difference in a very serious condition. The most important advantage that monoamniotic twins can have is knowledgeable parents who are willing to go to bat for their at-risk twins and insist on the best care possible.
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