18 Week Ultrasound: Getting to Know You

by longtallyarn

So yesterday we had our level 2 ultrasound.  The big news is that the technician and doctor think both our babies are boys.  I had tea parties with princesses in mind, and I have had a feeling that at least one of the babies was a girl.  However, I’m sure I’ll learn to love digging and demolition because it appears that my intuition was wrong in this instance.

In other news, they are both measuring right for their age.  We were at the maternal-fetal-medicine clinic for about an hour and a half, undergoing this ultrasound.  They measured the leg bones, arm bones, the skulls inside and out, the distance between the eyes, they looked at the blood flow pattern to the umbilical cord, checked the marker for downs syndrome, looked for cleft palate, and many other things.

At first the babies were head to toe and kicking each other in the head.  This probably foreshadows things to come.  Baby A, which is what ultrasound technicians call the baby on the bottom, who would be born first in a traditional delivery, is the one on the left, and was very active.  Baby B was trying to rest by the time she started on his measurements.  The technician was sure from the start that A was a boy, but she wouldn’t make a call on B.  The doctor came in and determined that he was a boy as well.

We have also had our first appointment with Wake Med high risk obstetrics.  They took a lot of time with me and seemed kind and helpful.  I think I am going to like them better than Mid Carolina, so I guess it is for the best that Mid Carolina let me go.  At Wake Med I saw a Nurse Practitioner who works with the OB, and other NPs who serve as dieticians and diabetes educators.  As a high risk clinic they wouldn’t see me if I weren’t having twins or some other complications.  Maybe this is why they were so attentive, but my first visit with them involved more exchange of information than my three visits to Mid Carolina combined.

Items of interest:  They deliver the baby at 38 weeks, either by induction or by Cesarean, if it has not decided to come on its own by then.  Not sure I agree with this philosophy, but since twins usually come early I probably won’t have to worry about the deadline.

Residents at Wake Med deliver the babies for this clinic.  Therefore I will not be able to meet the person who will be delivering the babies, unless I request to meet some of the residents when I am nearing the end of pregnancy.  Residents switch out every 12 weeks.

I will be getting an ultrasound every 4 weeks starting at week 24 to make sure the babies are growing properly.

Toward the end of the pregnancy they will begin looking at the babies every three days to make sure neither is in distress.  This is in response to a mysterious phenomenon in which diabetic mothers are more likely than others to lose a baby at the very end of pregnancy.   They told me that if a baby looks responsive and healthy it is likely to be healthy for the next 72 hours but if it appears to be in distress or insufficiently responsive they will deliver it early.

If I want a Cesarean, I can request one, simply because the babies are twins.  However, they reminded me that it is still considered a major surgery.  The NP said that predicting how a twin delivery will go is a “crap shoot.”  Her exact words.  If I want a traditional delivery I am welcome to try for it, as long as the bottom baby is head-down.  The reason twin mothers sometimes request Cesarean is that after delivering the first one vaginally, if the second one becomes distressed, it may still need a Cesarean.  In that case the mother has two major events from which to recover.  She said once Baby A emerges via a traditional delivery, sometimes the doc can reach in and pull out Baby B, even if he is in the breech position.

I asked if I will be able to travel up to WV for the holidays.  New Years will be in the 28th week.  They said as long as I’m not flying and if I haven’t been having preterm labor it will be OK to travel at 28 weeks.  If I have been having preterm labor symptoms it is not recommended.  Not because travel will cause complications, but because I won’t want to be too far from my hospital or on the road if problems start.