MoMo Twins

Last Friday, I went to my first appointment with the perinatologist.  The main purpose of this appointment was to see if the two identicals were sharing a sac.  At our previous ultrasound with our RE, she told us she was unable to tell if they were.  We knew that if they did share a sac, that brought on a whole new mess of complications and risk factors.

So I went to that appointment the day after our scare that landed us in the ER.  The doctor was very thorough during the ultrasound.  He looked and looked...and looked and looked, trying to find a membrane separating our two identicals.  I was starting to realize there probably wasn't one, but at that time, I didn't really comprehend the severity of the situation.  The doctor had the nurse look and then called another doctor in to look as well.  None of them saw a membrane.

They concluded we had monochorionic-monoamniotic twins, meaning they are sharing both a placenta (monochorionic) and amniotic sac (monoamniotic).  This happens when the embryo splits late (between days 8 and 12).  Apparently this is very rare and only occurs in 1 out of 10,000 pregnancies and 1% of twin pregnancies.  I couldn't believe this.  We already beat so many odds by this split happening in the first place.  How could this now also happen???

The biggest concern with these types of twins is that they have skin-to-skin contact and their cords can easily get tangled or compressed.  This is often something that happens later on in the pregnancy when there isn't as much room for them to move around.  Pretty scary stuff.  When I got home from our appointment, I Googled monochorionic-monoamniotic twins and found out the following:

• These types of twins are often called "MoMo Twins"
• Complications include Twin to Twin Transfusion Syndrome, cord entanglement, and cord compression
• There's a 50-60% survival rate for MoMo twins
• MoMo twins always deliver early because it is too risky to keep them in the womb.  My doctor told me he would not let me go past 32-34 weeks.
• Many women who are pregnant with MoMo twins are admitted to the hospital between 24 and 28 weeks for 24/7 monitoring.  If any sign of cord complication is found, they will immediately deliver the babies.
• MoMo twins are always born via C-section. 
• 75% of MoMo twins are girls

Needless to say, last weekend was a very emotional one.  I pretty much just stayed on the couch with my laptop, researching this condition while crying my eyes out.  I'm in a better place about it all now.  I'm still worried at how this could all end, but I'm trying to be as optimistic as I can.  It'll all work out...