Twin-Update: sIUGR – the new vocabulary to learn

Dizzy sunrise over Kassel

It is early Tuesday morning and as I am writing this I am eagerly awaiting the doctors’ rounds in the hospital to convince them to release me today.

It is not a normal Tuesday, today my step sister is getting married which is the only reason I am in my home town Kassel. The babies gave me yet another scare and I was put on bedrest for the time being. One would think that is gets easier, but as time goes on, my tummy grows and this pregnancy wears me out more and more.

I have been receiving a lot of love and support in the last weeks and I am truly thankful for all of it. I have decided to be more open about what is happening no matter the outcome because I am hearing and seeing lots of people struggle: with getting pregnant, with complications, with loss, with postnatal issues such as career nose-dives.

And as many of you know I am not planning to become a stay-at-home mom, I am not planning to give up triathlon training and my active lifestyle, I am not planning to stay in Germany for too long. Yet, being pregnant comes with many people throwing their opinion and advice at you (or even better: German folks knowing already what I am going to do and how I am going to feel) and even without weekly visits to prenatal specialists and the constant fear of potential loss on mind I am finding myself in a mudpile of feelings questioning a lot of things, especially the role of women and family policy in Western countries.

Selective Intrauterine Growth Restriction

Before getting into that rant, however, here are the facts: I am in my 24th week of pregnancy, both girls (yes!) have active heartbeats. While we had been prepared for a complication called “Twin-twin-transfusion-syndrom” where the blood exchange between the babies is becoming one-dimensional with one baby being the donor and one the receiver, it has turned out that the babies have a very rare different condition called selective intrauterine growth restriction (sIUGR). For reasons unknown, one twin is not getting enough from the placenta, thus staying behind in development. So far we have a 28% growth discordance. Some twins are born with one being half the size of the other.

SIUGR is categorized into three different types depending on the blood flow pattern in the umbilical cord. When the minimum criteria were met for our baby to be called a growth-restricted twin the doctors were under the impression that we are dealing with type 1. Type 1 means that both babies have a good chance of survival and they can make it beyond 30 weeks of pregnancy.

Right before Easter the doctors noticed a connection between the babies that had a blood flow pattern that was all not too great. We were sent home with the option of terminating the growth-restricted twin (that’s what I mean when I talk about little scares).

One week later, after we had taken a break in Croatia, soaked in some sun and rested a lot, the little one’s heartbeat was much better.

Treatment of sIUGR

We are now doing something called “expectant management”: monitoring the babies each week, taking it day by day. The next four weeks will be critical. Technically, the babies have reached liveability, but since the little one is almost two weeks behind her chances are pretty daunting currently.

The doctors & staff at TU Munich’s hospital have been very helpful, explaining everything to us, comforting us, always making time.

I will give more updates soon.