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Thursday, April 23, 2009

50/50

Ever since we found out a few months back that Nicole was carrying twins, we've been in the world of long odds. We learned that the odds of having twins are about 3 in 100 (a 3% chance). Among those 3% of pregnancies that are twins, an even smaller percentage are identical twins. About 1/3 of twins are identical. So now we're down to 1%.

Ok, among identicals there are a few ways that the twins can be arranged. Rather than trying to explain it, I'll refer you the diagram below. So the first one (di/di) is where the fetuses each have their own placenta, inner sac, and outer sac. With a 9% mortality rate, this is the safest configuration . It occurs 18-36% of the time.

The next one is mono/di, where the each fetus has its own placenta and inner sac, but they share an outer sac. This happens 60-70% of the time with identicals. This is the configuration that all of our doctors throughout the pregnancy thought we had. This setup has a 25% mortality rate, due to the dangers of twin-to-twin transfusion. So, not quite as safe as the first (di/di), but fairly safe due to the presence of a thin membrane separating the inner sacs.

Well, we found out in the middle of the cesaerean section that we were lucky enough to have the next variety (mono/mono). This configuration occurs in about 1-2% of identical twin pregnancies. So the odds of having identical twins in the same inner and outer sac are about 1 in 10,000 pregnancies, or about 0.01% (that one hundredth of one percent).

So, why all of the fuss? So what if the twins had an odd gestational configuration? Well, here's why this is significant. The kind of twins that we just had (mono/mono identicals) have a 50% mortality rate. That's right, 50/50. Luckily, I tell you this chilling fact with the comforting knowledge that our girls are perfectly fine now and show no signs of any long or short-term complications.

The potential problem with mono/mono twins is that there is no membrane that separates the fetuses and their respective umbilical cords. Because of this, there is a great risk that their umbilical cords can become entangled. I saw this first hand yesterday morning in the OR during Nicole's c-section.

Dr. Bev (short for Beverly) had already delivered Ainsleigh and was in the process of pulling out Annabelle when she exclaimed in her unmistakable Caribbean accent, "Whoa! Look at this! I can't believe it! Wow!!" I was behind the curtain with Nicole (well, her head and arms, that is) and had no idea what she was getting excited about. Then I peeked over the curtain and saw this (and snapped a photo).

Dr. Bev then said that she had never seen two umbilical cords that were so tangled. They looked like the girls had been braiding them in utero! So it was a good thing that we got them out when we did!

We also learned today that the standard protocol with mono/mono twins is to admit the mother to the hospital at 24 weeks into the pregnancy. She is then put on hospital bed rest and constantly monitored for the rest of the pregnancy. That means that Nicole would've been in the hospital since Valentines day! Knowing now how it worked out, we're glad for Nicole that they didn't catch this earlier.

This pregnancy and birth we're truly a miracle and we are grateful to the doctors, nurses, and most of all to our loving Father in Heaven for his divine providence. Against all odds, we've been blessed with 2 beautiful, healthy little girls.

7 comments:

Karen said...

Wow, that's amazing!! Congrats...they are beautiful!

Ann said...

What a miracle. Miracle after miracle! I am so grateful that everything turned out so safely! What tremendous blessings!

Love you!

Emily said...

They are absolutely gorgeous!! Remind me next time I see you that I want to talk to you. YEAH!!!

The Charters said...

What a blessing that all went well. They are adoreable Nicole! Congratulations!

Michelle Dermyer said...

Wow...how incredible is that? Thanks for posting more pictures!! Now, did Nicole end up going into labor on her own or was there a reason she had the twins this early? Inquiring minds would like to know!

Anonymous said...

Nicole- I saw your beautiful baby girls and your wonderful, supportive husband, your darling giants, and you cute girl. Way to go. I am so excited for you and am glad you finally have your little ones home. I will be thinking of you and praying for you. You are great!!! Love, Mindy Sue Matson (Speirs)

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