By Brook, San Diego, CA USA
PROM at 20 weeks + 5 days. Delivery at 29 weeks.
Story added: 2005-05-15

I wasn't surprised to learn that I was pregnant with identical twins during my first perinatologist appointment at 11 weeks. I had been telling everybody I thought it was twins, and the only reason we even did an ultrasound was that I told my doctor that I thought there was more than one. From the beginning it was a complicated situation -- I had given birth only 8 weeks before conceiving the twins, and that pregnancy had been complicated by an abruption at 14 weeks and placenta previa. We did have a small abruption at 14 weeks again but it resolved and I was very optimistic that everything would be fine. When I was 19 weeks along I had an ultrasound done that showed my twins had developed twin-to-twin transfusion syndrome. I was devastated! The odds were very low that my twins would survive. My donor twin had so little amniotic fluid that he was "stuck", literally pressed up against the side of the placenta with his amniotic sac saran-wrapped around his little body. He could barely move. My recipient twin had 4 times the normal amount of fluid. Nine days after I was diagnosed, I woke up one morning just feeling that something wasn't right with my body. I called my doctor who told me to come see him in the L&D triage. When I got there, we found that I was in preterm labor and was 1/2 cm dilated. I was 20 weeks, 5 days along. It was recommended I have an amniocentesis to reduce the amount of fluid in my recipients sac, hoping to stop the labor which started as a result of me being so big. I was admitted into the hospital and the amniocentesis was done. Only about 700cc of fluid was withdrawn, and after the procedure, I was hooked up to a monitor for what was expected to be a few hours before they released me home. 15 minutes after the amniocentesis was complete, I had a HUGE gush of water. I knew immediately that my twins were in even more grave danger than they had been before. My doctor and all of his colleagues were very honest that it was unlikely that the pregnancy would continue, but none of us gave up hope. My nurses and doctors prayed with me. I stayed in the hospital on complete bedrest for 8 weeks 3 days before the boys were born. During that time, I had several marginal abruptions and was transferred from the perinatal special care unit to L&D, then back. Strangely, I had a second rupture on twin B at 24 weeks. I literally laid there with a bath towel as my pad, I was leaking so much fluid constantly. We estimated that I was losing at last 800cc of amniotic fluid a day between the two babies. They both were "stuck" now -- their AFI's were always below 2 and it was very scary. When the boys were born via emergency c-section at 29 weeks, nobody really knew what to expect. Twin A (recipient) was born weighing 2 lb. 12 oz. He had severe RDS and was on a ventilator for several days, then a nasal CPAP for a couple of weeks, then oxygen via a nasal cannula for 8 weeks. He was also born with severely clubbed feet due to his cramped living quarters. He had moderate renal failure for the first 4 days of his life. Twin B (donor) was born weighing 2 lb. 7 oz. He was only on the ventilator 24 hours, then nasal CPAP for 4 days and oxygen for 3 weeks. He was born with severe renal failure which didn't resolve for 3 weeks after his birth. We came very, very close to losing him! The boys spent 71 days and 66 days in the NICU and are now almost 5 months old. They are doing wonderful! To look at them, someone not familiar with our story would never guess they had come so close to death -- they are healthy, happy little boys who appear to be developmentally appropriate. I know our story is a bit unusual in that both babies ruptured, but I hope that it gives someone hope to continue on. Miracles do happen!