13 answers

Twins in a Single Amniotic Sac

I am currently 24 weeks pregnant with twins who are in the same amniotic sac. This is a rare, but not totally uncommon, condition. It just means the egg split too late for the babies to form their own bag as multiples normally do. Fortunately, they are not conjoined; however, my doctor says that they need to be delivered at 32 weeks to minimize risks of them strangling each other. So, I am looking to connect with other moms who may have been through this or are currently going through this. Did your doctor recommend/insist on early delivery? Recommend bed rest? Any advice? Thank you.

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I haven't been through this, but I do have twin friends who are just the kind of twins you're describing. They're mirror images of one another (mole on the right arm, mole on the left) and are now 28 and both perfectly healthy! Good luck with the delivery and know that everything definately can go okay!

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I would get a second opinion on this. 32 weeks is very early for a planned cesarean, especially when there are no actual problems present.
Your doctor should monitor you closely and assess how much their cords are actually entangled, if there is a risk of cord compression and what the risk-benefit scale is in your specific case.
Depending on your case, your babies may benefit from an even earlier delivery or, you may go to 34 or 36 weeks without a problem. Every patient is different and a physician who tries to prescribe you a one-size-fits-all approach is not doing a very thorough job.

I do know someone who had twin girls who shared a placenta - so it sounds to me like the same or a very similar situation. In her case (she herself is a pediatrician, so I know she had to have researched it too), she was on bedrest in the hospital for a number of weeks at the end - I think so that they could keep an eye on the babes, and she ended up delivering vaginally. I am positive it was not 8 weeks early - but probably more like 4ish. She delivered at Evergreen Hospt in Kirkland, which I think had the experts on these cases. 8 weeks early is very early!!

May I suggest you contact Jennifer Gallardo at Andaluz Waterbirth Center. She is giving a lecture on twin births and I would bet that she could be a wealth of information!

Best of luck!
T. Nelson CD (DONA)

I have a friend who had twins who shared the same amniotic sac. I don't remember how early they were delivered but I could check with her. I do know she was on bedrest for a good portion of the pregnancy and in the hospital for a good number of weeks as well (for constant monitoring). She has an older son, so in a similar situation to you. She lives in Bellingham, if you'd like I could get her info and put you in touch with her. Good luck and take very good care of yourself and those little ones! It's definitely a much higher risk than a typical pregnancy, or even a typical twin pregnancy, so I'd say take all the precautions you possibly can.

I have no idea, honestly but would like to say congrats not only on your babies but of seaking out more information.I personally would see a 2nd, even 3rd Dr for thier opinions because 8 weeks can be tough on any baby, specially twins who are normally a lil smaller to begin with because of having to share thier space.I hope everything works out for u and u can hang in a little longer the your daughter is pushing for right now.
Good luck!

Just wanted to send positive thoughts your way!
We have 8 month old triplets, that were in different sacs but came at 31 weeks. The NICU is a tough ride but at 32 weeks your babies should do just fine.
Congrats on twins...I love being a multiples momma!!

Let me also add...my MFM (maternal fetal medicine spec) was/is Dr. Winkler. He is at Legacy Salmon Creek in Vancouver. He is EXCELLENT and if you are looking for another opinion I would go see him! He got my babies here safe and sound...after I spent 6 weeks on hospital bed rest. They almost came at 25 weeks and he was very instrumental in saving them and getting them more baking time.

Congratulations - having twins is an amazing adventure. Mine just turned 7 this last week. I would recommend looking into the Eastside Mother's of Multiples group. They have a website and are an amazing resource. Lots of moms of multiples, lots of experiences, lots of stories. The website is www.emoms.org. Good Luck! And congratulations again.

Hi J.,

I am a mo/mo twin. My mom delivered us naturally 29 years ago at 36 weeks. She started having contractions at 32 weeks so they put her on bedrest in a hospital until the contractions started again at 36 weeks and decided to deliver. She was at a military hospital in Tacoma and this situation had not been seen very often. There were no complications during the birth or with us afterwards.
32 weeks just seems a bit early to deliver with no exsisting complications.
Good Luck! I think twins are great. :)

My friend had mo/mo twins and delivered at 34 weeks. I am assuming you are seeing a perinatalogist? If not, go see them right away! If you are in Seattle, I recommend Swedish Perinatal Medicine. That is who I am seen by (I had a high risk twin pregnancy last time for different reasons) and they are good. My friend with the mo/mo twins was also seen there. I think it is their policy to try to get their high risk pregnancies until at least 34 weeks.

I haven't been through this, but I do have twin friends who are just the kind of twins you're describing. They're mirror images of one another (mole on the right arm, mole on the left) and are now 28 and both perfectly healthy! Good luck with the delivery and know that everything definately can go okay!

I don't have any answers to your questions but wanted to send you my support. I think you are wise to seek out other's stories and perhaps seek a second opinion. It certainly is not ideal for babies to be born 8 weeks early and there is risk of many complications after birth. Perhaps it is necessary but I'd want to be sure of the actual risks if it were me.

If your labor does have to be induced that early, at least they should be able to treat the babies with steroids to speed up their lung development and increase the chances of being able to breath on their own at birth.

Congratulations on your twins! I have twin boys and an older son - all I can say is , it's amazing! About your pregnancy, have you been seen by a perinatologist (an ob/gyn specialist)? My twins are fraternal, so I didn't have the sac problem, but I had lots of unusual and scary complications and the advice I had from a perinatologist was so much more insightful (and very different) from my regular ob. I really recommend seeing one if you haven't already. If you do deliver at 32 weeks, then don't worry - lots of babies born then do really well and twins tend to devolop a little faster than singles. HOpe this helps! D.

Earlier in the thread someone mentioned Jennifer Gallardo at Andaluz Waterbirth Center. Here is the website: http://www.waterbirth.net/

She was one of the midwives who delivered my twins two years ago. She is a great font of information if you are wanting a less medicalized pregnancy and delivery. Jessica Dolin at Andaluz is also extrememly knowledgeable about twins and breeches.

I did not have this issue with my twins being that they were fraternal, however in all of my reading having a c-birth at 32 weeks seems a bit preemptive especially since at this point (assumption) there is no indication that they have wrapped cords.

I am sure you have been reading many books, one of the best ones I found was Having Twins and More by Elizabeth Noble. She spends equal amounts of book space to medical issues and potentials as well as options for midwife/homebirth. She tries to let you decide what you want while giving you the options of both worlds.

If you would like to talk give me a holler off list. I do believe there are times when Dr's are the best route. I have found for myself that following my insticts (intuition, workings of God) that you will ultimately make the right decision as long as you follow what is in your heart and head.

When I thought about having a hospital birth with my twins, I had the deepest sense of doom, I couldn't go through with it. When my daughter was born, it became evident as to why. She was born with a dent in her head over the veins that bring oxygen and blood to the brain. The surgeon who worked on her said that if I had delivered her by c-birth she would either be brain damaged or dead. So follow what your heart is saying when you think of all the options.

Good luck mama, it isn't an easy road (especially when you go against what other people think you should do) but it is a worth while road.


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