Thursday, June 27, 2013

Meeting Houston Perinatal Consultants (Part3)

Every Friday a member of Houston Perinatal Consultants would come over to College Station to see clients in this area and they rotate each week. Thankfully this was perfect for us since getting a sitter for all day would be difficult.

The first appointment was with Dr. Reiter. Brandon couldn't come so I went by myself. He was very businesslike and had his technician start the scan right away. They determined that the boys were indeed identical and needed intensive monitoring because TTTS can progress quickly and suddenly. The cutoff date for laser ablation to separate the vessels that connect the boys can only be done before 26 weeks. After 26 weeks, the babies are instead delivered. The most important reason to get the more advanced scans was to evaluate blood flow with a Doppler. Each boy had blood flow measured in the umbilical cord, a large artery in the head, the liver, and placenta. The heart is studied closely and each boy measured to ascertain growth. The kidneys and bladder are observed as well. The amounts of fluid are also measured because the first sign of TTTS is fluid discrepancy and disappearing bladder volume in the donor twin. Each scan took between one and two hours because so many facets were being monitored. Dr. Reiter was optimistic and said the boys were looking well and we would check again in two weeks.

Two weeks later (20 weeks) both boys showed good progress but the size discrepancy was increasing. We scheduled another scan for two weeks following but the office called and cancelled so it was three weeks before I was in for another ultrasound. Meanwhile I began to see an OB every two weeks.
When we made it to the scan at 23 weeks we were quite alarmed to hear that the boys had TTTS. The big twin had some enlargement around his heart, high amniotic fluid levels and the smaller twin was showing some abnormal circulation in his umbilical artery. We were immediately referred to the maternal/fetal medicine specialist (MFM) in Houston, Dr. Kenneth Moise. Our appointment was scheduled the next business day which was Monday. We were sent an informative video about TTTS and had a stressful weekend. I think it's impossible to watch that video and not cry when the mortality rates are laid out there. I was also a bit confused that we were diagnosed as having TTTS when we did not fit the criteria of low fluid on the donor twin.

Things were not looking good.  We asked for prayers from everyone we knew.

Links to the detailed story:

Ultrasound reveals all (Part 1)
High risk here we come (Part 2)
Houston Perinatal Consultants (Part 3)
Texas Fetal Center (Part 4)
The Final Stretch (Part 5)
Jesse and Max's Birth Story (Part 6)

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