The Beginning of our monoamniotic-monochorionic twin storie

Hello I am Nana of Jaycee and the expected twins. I am mom to Jora(18) and of Jade(20)who is mom of Jaycee and who just found out she is expecting MoMo twins. THIS is the storie of our journey....

In August at about 4 weeks Jade realized she was possibly pregnant . This was confirmed, with a visit to her OB, by a test and an ultrasound at 6 weeks. During this ultrasound only one baby was seen however jade kept having dreams that she was carrying twins. Jade has an 18 month daughter, Jaycee, during her pregnancy she had a lot of complications and a major case of postpartum depression afterwards. It was decided that often visits to the OB starting at the beginning of this pregnancy would be best. So two weeks later we were back for another exam.  I was sitting outside with Jaycee when Jade called and said mom you need to come in there really are two. I laughed and told Jade this isn't something to joke about she replied MOM come in here NOW. I was in shock twins run in the family, Jade had had 4 or 5 dreams that she carrying twins but I still didn't think.... 

We were sat down and shown the pictures of the two babies and their two yolk sacs. I was so overwhelmed I asked no questions. Jade is only 8 wks at this time you can see a lot with the little ultrasound but not enough so we were asked to go to the hospital for a regular ultrasound which we did. Everything looked good and the twin pregnancy was confirmed. Oh my there really are two. Many emotions were coursing through us excitement and fear,  so many feelings it is hard to put into words.

It wasn't until a little time had passed and the reason for the fear came to light. I started freaking out yes twins run on both sides of my family, going way back to when our families were still in Europe, but the out-come in recent generations has not always been good. My dads mom had carried two sets of twins one fraternal and one set identical. The fraternal twins arrived with no problem but with the identical set one thrived(my father) and one was still-born having not got enough blood and nourishment through his cord. Could it have been cord entanglement or TTTS? We don't know for sure because this was almost sixty years ago. We have limited information but from everything that has been disclosed it sounds like a MoMo pregnancy with possible TTTS. On the bright side my grandmas sister delivered perfect identical twins. There are a set of twins in every other generation on my mothers side. My mothers sister lost twins going into the second semester at this point I couldn't remember if there were fraternal or identical so I called her. I am sorry but I felt a little relief finding out that she lost her fraternal twins in an accident that was too traumatic on her body. I was very sad she had lost them but at least it was not another issue with carrying them. Then there is my sister who lost her MoMo twins at almost six months to TTTS a few years back. With all this loss I am scarred out of my wits and need to know what we looking at.  So I have Jade call the OB and explain our concerns. She said that she will look at things at next weeks appt to see what she can see. When we arrived at the Dr we are ushered in for an ultrasound again on the small office machine and numerous times are told there doesn't look to be a membrane between the babies. The one good thing that we knew at this point was the babies were not conjoined cause the were laying with their heads next to the others feet. We were told we will be able to see more at the ultra sound next week. So I get home and start doing my research. I am devastated by all that I read. It is so overwhelming and I decide not to share with Jade all the info I have read. Not that she doesn't have a right to know but with everything in our family that she already knows I don't want to scare her further until we know for sure. 

On 10-10 we head to the high resolution ultrasound, I am armed with questions(thanks to monoamniotic.org). Five minutes into the ultrasound the tech said I am not going to be able to answer any questions I will be getting the Doctor to come in here after I take some measurements. Right after she said that the babies lips came together as if kissing then there hands started touching each others faces. They are now laying head to head. It was bittersweet but I knew what the Dr was coming into talk to us about. The Dr came in and moved the wand around looking and looking but could find none. There is no membrane the twins are in fact MoMos. The Dr turned out to be the perinatalogist that Jade was now going to be seeing. She answered questions before we could ask them. The key one being inpatient will begin at 24 to 25 weeks. She is wonderful and we are very happy that she is taking over Jades care. Jade had a hard time taking in all the risks and possible outcomes. She panicked but .....

She is enlightened now and ready to beat the odds.

look at the love already

Jade and Jaycee 05/11

Jaycee 10/12

Here are some statistics
About MoMo Twins
Monochorionic/Monoamniotic

• 75% of MoMo twins are girls
• MoMo twins are always identical, they are always the same sex: either two boys or two girls. Like virtually all monozygotic twins, they are the same gender because they derive from the same gene set.
• MoMo twins are very rare. Only 1 percent of all twin pregnancies will be monoamniotic.
• The survival rate of MoMo twins is estimated at about 60%.
• Mothers of MoMo multiples should be cared for by a perinatologist (obstetrician specializing in high risk pregnancies),.
• MoMo twins are often misdiagnosed in the early weeks of pregnancy when the membrane is so thin as to be nearly invisble. Often a later ultrasound reveals a dividing membrane confirming that twins are actually MoDi (Monochorionic, Diamniotic).
• MoMo twins are the result of a late splitting egg; one that split around 8-12 days after fertilization
• MoMo twins share a placenta and amniotic sac which means they have skin to skin contact
• MoMo twins are considered extremely high risk because of the risk of cord compression leading to fetal death as a result of umbilical cord entanglement
• MoMo twins are always delivered by C-Section
• MoMo twins are usually delivered between 32-34 weeks gestation because the risks of staying in utero are greater than the risks associated with a premature birth



This is the biggest threat to MoMo twins

• inpatient monitoring at viability yeilds the greatest success rates 
• Most Perinatologist give you the choice of going inpatient between 24 to 28 weeks. You have to decide if you comfortable with the statistics of a micro-preemie and what stage. We are just praying to get in and make it to 32 weeks. Here is the difference between a 24 , 26 and 32 week preemie.
  
  Stats at 32 weeks
  98% chance of survival
  7% CLD (Chronic Lung Disease from the ventilators and being on oxygen for so long)
  1% NEC Necrotizing Enterocolitis (Parts of their bowels can become infected a die due to not being ready for milk)
  NA for PDA (the valve not sealing to create a separation of the 4 heart chambers. This generally happens with the babies first cry).
  1% IVH (level 3/4) These are severe brain bleeds that can lead to Cerebral Paulsey and other behavioral disorders.
  0% ROP (This is a Retinopathy of Prematurity can lead to blindness)
  
  Stats at 26 weeks
  84% survival
  34% morbidity (Severe IVH,CLD,NEC, infections ROP)
  44% CLD
  
  9% NEC
  48%PDA
  9% IVH
  5% ROP
  Stats at 24 weeks
   66% to 80% survival