We hit the 30 week mark which is fan freakin tactic! We had our supposedly last appt yesterday at our safe haven UCSF with Dr. Rand. We had our ultrasound and then we hung around for a few hours at Burgermeister while we waited for Dr. Rand to arrive and review our case. We really wanted to talk to him so we could wrap up any lingering questions, get the placenta box, and decide our course for the next 6 weeks. Since we have been a little unhappy with our treatment in Sac we wantd to go over that with him and get his views and see what he could do to push our Sacramento office to get us the care we need. UCSF seems to be miracle workers and they make a call to Sacramento and amazingly things get done. Funny how that works. BTW, burgermeister on Carl St in S.F. is sooooo good and if you are ever in the area check it out.
For the results of our appt we are doing phenomenally well. My inner goddess is doing arabesques (haha if you are reading 50 shades of grey you will get that.) If not, it means Im over the moon sort of :) The bladders on both babes look great as do the kidneys, brain, gallbladders, stomachs, dopplers, cerebral blood flow, and fluid levels. I feel so blessed to be at this point. The fluids have normalized about 6 cm for baby A and 5 cm for baby B. The sonographer tried to get 3D images of the girls and the best we could do was a mouth and nose of baby B. The amount of room for twins at this point I think is running out and we may have missed the window for a good 3D pic. Luckily, we got one back at about 16 weeks that was really good of both girls faces. (see pics below). The weights for the babies are A a whole lotta nearly 4 lbs at 3lb 15oz, and baby B at nearly 3lbs at 2lbs 15ozs. So, they are 1 lb difference and that makes then still holding steady at 24-25% difference. It is good that this size discordance has not worsened. Like I have said before that even though 25% is a lot, in our case it isn't disconcerting because baby A is in the 90th percentile and baby B is right on track at 50th percentile. It would be more alarming if A was normal and B was behind her at the same difference in percentage (clear as mud.) Sorry if it is confusing but bottom line is things are good!
After a long discussion about how my treatment and the girls health should be monitored in the next six weeks we came to a few conclusion that I am happy with and they are as follows:
1. We need to have growth checks every 2 weeks from here until delivery. UCSF told me if I go to Sac in 2 weeks and I am still not confident in their assessment that I can come back to see them at the next 2 week appt. This works for me. They are also going to write up an extensive treatment plan to send to Sac telling them I need to be seen every 2 weeks and not 3 like Dr. Chyu had tried to do.
2. I originally thought weekly fluid checks were necessary as well but Dr. Rand feels that it is over the top and not necessary in my situation. I feel that coming from him I respect that and will abide by that recommendation.
3. I need to start having non-stress tests 2x per week starting at 32 weeks. This will help to determine if the babies are getting stressed in utero and might do better out than in. They will monitor HR at the hospital for a period of time 2x per week.
4. They do want to have my placenta and we will give Dr. Juhn the box and will get all kinds of data regarding inter-utero life for the girls. It will help for future people in this situation and give us insight as to why our pregnancy took the course it did. A win-win.
5. I will get steroid shots to help develop the girls lungs closer to the date when they think I will deliver if time permits. It takes I believe 48hrs for full effect and lasts 7 days so about a week before delivery I should get those but if i look like I might deliver early I may get them early and hopefully 48 hrs prior to delivery.
So lots of appts are in my near future which is relieving for me because I know we will be monitored closely because since we are at a good viability I don't want anything to be missed that we could have caught early. I feel much better having gone to UCSF and they will always have a special place in my heart and I appreciate everything they do!! They have it down over there.
The only thing that I am now on the fence about is C section vs. vaginal delivery. I had discussed this with my OB and we had decided that a c section would be best because Baby B has such a smaller share of the placenta that labor might be hard on her. I really don't want to vaginally deliver A and then have to have a c section for B. However, after talking to Dr. Rand he HIGHLY recommends that I give a vaginal delivery a try for a few reasons- it is safer for babies and mom, it will be better healing, and I won't really know if baby b will have a hard time with labor unless I try. He said if I were delivering at UCSF he would really push me to try to deliver vaginally if both babies are head down. At this point A is head down and B is breech. Things could change but he would deliver A and if b remained breech would do a breech extraction because the cervix has already opened enough for A that delivering B feet first is appropriate only in this type of situation. He also said this is something they do but not all regular Obs might be comfortable with this type of delivery. I don't think Dr. Juhn would be open to this and quite frankly it worries me. So, I may continue to think about this and if either baby is breech at delivery I think I will opt for the C section. If they are both head down I may try to deliver naturally. Time will tell. I want to do whatever will have an end result of 2 healthy babies and a healthy mom.
All in all we are trucking along and I am thrilled with how things are going. Im hoping Baby B will continue to gain weight and we can make it to 36 weeks. Happy Memorial Day Weekend!!
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