20 weeks

Today I go see my new doctors in Fairfax at Perinatal Associates. Before I go, I just know they’re calling it a ‘first ob appointment,’ so Scott doesn’t go with me. Big mistake.

Since we’re at the 20 week mark, they do the full 20week scan. We don’t get good news.

Baby B has not grown, and he’s now 49% smaller than his brother.

What do we do??? Because I’m only 20.5 weeks, it’s way too early for either baby to be viable, so just letting it play out is risky…..so do we preempt? If so, baby A gets a full chance of survival. If we don’t intervene and wait, then we could possibly make it to viability. but with no growth in 2 weeks….that’s unlikely. If we don’t intervene, wait, and baby B dies, then baby A becomes at risk of death and/or severe brain damage.

Already dealing with the possibility of losing one baby is bad enough…the possibility of losing one and having one with brain damage is killing me. I just can’t do it.

We’re going back to Baltimore in 2 days. We’ll see if their numbers confirm, or if this was a fluke with different equipment and different sonographers.

We think we have 3 options, though the third option isn’t something Baltimore likes to do, maybe if we ask they have to do it???
assuming that Baby B truly has achieved no growth, the chances he’ll live are slim to none. So based on that, we have to make our decisions.
1. We preemptively do umbilical cord occlusion: http://www.obgyn.umm.edu/ttts/therapy.html#umbilical. This is where they basically clamp his cord and he dies in utero. B/c he gets clamped, his death shouldn’t affect baby A.
2. We continue waiting to see if anything happens. This poses several risks….if Baby B were to die say Thursday, and my next appt isn’t till the following week, Baby A will most likely die and/or suffer severe brain damage. At this point, neither baby is viable so they can’t do an early delivery yet b/c neither would survive. Even if I could make it to 28 weeks or so, Baby B probably wouldn’t survive if he’s still not growing.
3. We get the laser surgery. This would sever all blood vessel connections between the babies. If Baby B were to die, his death would be like in #1 above and shouldn’t affect Baby A. If he’s to continue growing, he gets to fight it out on his own. Of course, getting the surgery isn’t without risks to both babies b/c it’s intrauterine surgery.
At this point, not having talked to any other doctors, we’re leaning towards scenario #3. The laser surgery is the course of action with TTTS, which I still don’t have, but it’s also the plan we can live with right now….we give both babies a fighting chance. And if the one cant make it, the other isn’t affected. This to me is so much more acceptable that option #1. Of course, we don’t know yet if we can get the laser surgery. But there are several studies being done right now trying to figure out what’s the best situation with my exact scenario. The study divides the participants into two groups: one group gets the surgery, the other group waits. Pretty much the outcome will be the same with both….one or more baby will die.

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