Mono Mono Twins
Until I was pregnant with twins, I had no idea there were so many different types. Not only can twins be identical and fraternal, but they are also classified by how they share a placenta and/or sac. There are Di Di twins, Mono Di, and Mono Mono twins.
Twinning is determined by how early the egg splits during fertilization. If the egg doesn’t split all the way, the twins are conjoined. Next, Monochorionic monoamniotic (one placenta, one sac) happens, which can lead to complications because there are two umbilical cords twisting around in that same sac. Monochorionic (one placenta) diamniotic (two sacs) happen next, and they also have many complications because of that shared placenta. If two different eggs are fertilized, they will have their own placenta and sac (Diaminotic Dichorionic,) making them fraternal, or one egg could have split very early on, which means they are still identical.
Phew. It’s pretty confusing.
No matter how confused you may be, your doctor should not be confused. They should be able to determine if the twins are sharing a placenta and/or sac by your 12 week appointment at the very latest.
My doctor was able to tell that my twins were sharing a placenta at my very first appointment, which was 8 weeks. She wasn’t able to see if they were in the same sac or if there was a membrane separating them, so she sent me to a specialist.
If your twins are Mono Mono or Mono Di, you need extra monitoring and specialized care from a Maternal Fetal Specialist. Many twin pregnancies have no complications, but the ones that do, can be very serious, and I know this personally.
Today’s micro preemie miracles not only fought through a complicated pregnancy, but also through a NICU stay. Please meet these sweet girls, as told by their mom, Annie.
1. Tell us about your babies.
Caroline Grace and Rebecca Ann were born at 26 weeks and 5 days. Caroline was 1 lb 15 oz, and Rebecca was 1 lb 13 oz. They are Mono Mono twins, which means there is 1 sac and 1 placenta.
It’s a rare type of twins that only happens to 1 in every 10,000 pregnancies.
They are my 4th and 5th babies.
I went to Pasadena for TTTS (Twin to Twin Transfusion Syndrome) laser ablation surgery on my placenta at 22 weeks. Because these types of twins share everything, they wanted me to go into the hospital at 24 weeks for 24/7 monitoring. The cords could twist and knot, and it could have taken both of their lives.
2. How long was your NICU stay? What was the hardest part?
The girls were born on February 23rd, 2017. Rebecca came home May 26th, 2017, which was two days before my due date. So, 93 days, I think.
Caroline didn’t come home until June 6th, 2017.
Both girls had Bilateral IVH Brain Bleeds.
Rebecca was 4 and 4. And Caroline was 4 and 3.
Rebecca was intubated for the first 2 months, and Caroline for only 2 weeks. Then, she went to the cpap.
Rebecca required steroids to get off the vent. They tried two times unsuccessfully to get her off the vent before they gave her the steroids that helped.
Both girls where severely jaundiced. They where under the lights for the longest time.
The doctor suggested that I pull Rebecca off life support 2 days after she was born due to the complications: Apnea of newborn, Atelectais, Bradycardia, Breech birth, congenital anemia, Disseminated Intravascular Coagulation, Dysmotility of stomach, Hydrocephalus, Hyperglycemia, interstitial Pulmonary Emphysema, PDA, Heart Murmur.
Caroline was transferred to a different hospital on 5-16-17 to get a VP Shunt placed in her head due to her having Hydrocephalus. They where doing LP (lumbar punctures) every week, and sometimes 2 times a week. This started at about 2 weeks after birth because her head just kept getting bigger, and it wasn’t resolving.
Caroline had her shunt placement one week before she came home. The next day after the surgery, I was told to say goodbye. Her body was rejecting it. She was so swollen all over and began to have seizures. That has all since resolved. She does not have them currently.
Both girls have CLD (Chronic Lung Disease.) When Rebecca came home, she came home on Oxygen and a Pulse Ox Monitor. When Caroline came home, she didn’t require any assistance.
3.Do you know what caused your premature birth?
These are babies 4 and 5 for me. My 6th pregnancy.
Other than TTTS, I had no complications. I was in the hospital for 4 days when my placenta ruptured, and I bled out on the table.
4.How are you and your baby/babies doing now?
Both girls are happy and healthy. They coo and talk to each other.
Rebecca loves to smile and roll over. She even scoots on the back.
This journey is unlike anything else I have been through in my life. It hasn’t always been easy. I suffer from PTSD and PPD due to the whole thing.
Milestones aren’t really being met. But, We will get there.
Caroline starts PT (Physical Therapy) in October because she is very delayed. However, Rebecca is right where she should be.
No surgeries besides the one for Caroline.
We have been cleared from the Eye Doctor, and the Girls no longer show any signs of ROP (Retinopathy of Prematurity.)
5. What advice would you give to a new preemie family?
Don’t be afraid to ask for another nurse or doctor to explain things. If you don’t like they way your child is being treated, tell the NICU staff and have them changed.
I got blessed to have an amazing nurse who was with my girls from the beginning. I did tell one doctor she wasnt allowed to care for my children. She made me feel like they where a burden, and they were taking up space in her NICU. I refused to allow her anywhere near my babies.
If you have family and friends, don’t be afraid to reach out to them and ask for help. Even if it’s to wash your clothes while you try to nap.
It isn’t an easy journey, but you were destined to take it.
Thank you so much to Annie for sharing her precious Mono Mono twins with us. If you, or someone you know, is pregnant with twins, please make sure to see a doctor who specializes in twin pregnancies. If you need help finding the right doctor, please send me an email, and I can help you.
Any supportive comments or questions for Annie and her family can be left below.