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  1. #1
    Join Date
    Jun 2003
    Location
    AL, USA.
    Posts
    302

    Default Any advice if one twin has low amniotic fluid?

    We went in for my 21 week ultrasound this past Wednesday and everything looked pretty good but twin B has low amniotic fluid. The boys share a placenta and I've read up on TTTS and am wondering if we may be heading down that road. My OB wants me back in 2 1/2 weeks for another ultrasound. If I'm reading online information correctly I should be drinking lots of water and resting as much as possible. Do the Boost or Ensure drinks help with this also? Has anyone else BTDT with one twin having low amniotic fluid? I know there are other message boards specifically for TTTS but I wanted to see if anyone here had experience before I searched further.

    Thanks so much,
    Karla

  2. #2
    Join Date
    Dec 2007
    Posts
    33

    Default

    Congrats on your identical boys!!

    If you have any concerns about TTTS, please be sure to visit tttsfoundation.org. Then go to "official message board" and look for the "During Pregnancy" board. You'll get great info over there.

    FWIW, I think that your doctor wanting to wait 2 1/2 weeks is way too long. For our identicals, we saw a perinatologist that had experience with identical twins. We had weekly ultrasounds from weeks 15-22 to closely watch the baby's fluid levels, etc. Our doc said that most cases are seen during that timeframe.

    We are very fortunate that our girls don't show signs of TTTS. I made sure that my protein intake was very good. Many of the specialists recommend protein shakes, so definitely get started on those and/or add additional protein to your diet.

    Best of luck!!

    K

  3. #3
    Join Date
    Jun 2003
    Location
    AL, USA.
    Posts
    302

    Default

    Thanks so much for your response. I'll be sure to check out the ttts message board. I've started drinking the protein shakes and increasing my water intake. I also put a call into my ob this morning to ask for an ultrasound this week. I'm guess I'm just going to have to be more persistent that I be monitored via ultrasound more often.

    Thanks again!
    Karla

  4. #4
    Join Date
    Apr 2008
    Posts
    3

    Default

    How are you doing? Did you talk to your doctor yet?

    I guess it really depends on what they mean by "low". I had a biophysical profile at 34w4d and my Baby A had only 1 measurable pocket of amniotic fluid that they could find, and it was 1cm (they like 8cm or more). I was sent to L&D immediately and induced the next morning. My twins are fraternal so TTTS was not an issue.

    My guess is that your fluid level was considerably higher than that, based on their recommendations. It might put your mind at ease to ask what the exact levels were, but I would probably want an u/s sooner than 2.5 weeks too. Best to you and your babies.

  5. #5
    Join Date
    Jun 2003
    Location
    AL, USA.
    Posts
    302

    Default Our update

    I did end up going in for an ultrasound last week. I was 22 weeks at the time. Twin A had an AFI of 26.8 cm and Twin B had an AFI of 10.22 cm. My doctor did talk to me about the possibility of TTTS and is sending me to a specialist on the 21st of this month. I'm so anxious for that appointment so hopefully I can find out more. As far as growth they measured 22w6d for Twin A and 21w6d for Twin B at my 22 week ultrasound. I've been reading some on the TTTS message boards but most of what I've read is twins with much lower amnio levels so I'm not sure how we fit into that. Thanks so much for your concern and I'd love to hear anyone's thoughts on our latest.

    Karla

  6. #6
    Join Date
    Jan 2008
    Location
    chicagoland
    Posts
    272

    Default

    any updates?

  7. #7
    caheinz is offline Platinum level (1000+ posts)
    Join Date
    Dec 2003
    Location
    near the Windy City, IL, USA.
    Posts
    1,838

    Default

    I've poked around some on the TTTS boards, just because this pg is exactly the sort where there's a risk of TTTS. (It only occurs in identical twins that share a placenta, which is a small minority of all twins, and even of identicals.)

    If there's been a change in the relative sizes -- if they were measuring closer together earlier, then I think I would insist on being seen more often. I'm at 20.5wks now, and since 15wks, I've had an ultrasound probably no less frequently than every 10 days. (This next one will be almost 2 weeks, but that was complicated by my going out of town for about 10 days...)

    As of the last time for us, both boys were measuring almost a week ahead of schedule, and one was 1d bigger than the other. They've consistently measured that way, though, since 12wk. If this relative rate changes, I'll be concerned -- but I already know that my ob and perinatologist (I'm bouncing between them for appointments, and both do ultrasounds every time) are watching for it.

    The main thing about TTTS is that when it does happen, it goes downhill FAST. (Faster than 2.5 wks.) Many docs "prescribe" bedrest and at least 3 protein shakes (Boost/Ensure) a day on top of the diet you already had. The TTTS Foundation site has good info about the options, and there are even threads with doc recommendations in the forums. (Some options are dependent on having a doctor who can perform the procedure nearby.)
    mommy to three boys: A, 3/04
    and identical twins B and D, arrived 9/08

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