Tuesday, November 21, 2006

Surprise, Surprise

Alright, so we are having a baby. A few weeks ago, Audrey goes in for the AFP triple screen test. It is a normal thing to do and is intended to help determine whether the baby might have Down's Syndrome, spina bifida, and things of that nature. We had the test done when Audrey was pregnant with Noah and didn't see any reason not to do it again. I believe it is voluntary, but why not know this kind of thing in advance if you can, right?

So, the results come back and one of the indicators is a bit high. Not far out of whack and not something that couldn't be caused a number of normal conditions. For example, if you get the test done outside of a particular window, the results will have a high potential for false positives. Of course, the test already has a decent potential for false positives, so the timing is everything. Since we already had some concern regarding the inaccuracy of the due date, we figured it was likely that the test results were due to being outside the normal window in which the test should be administered. Armed with a good explanation, we still worried like crazy through the weekend. We were able to get an appointment with a perinatologist early the following week and just tried to keep our emotions in check until then.

So, we go see the perinatologist for a Level 2 sonogram. I can't really tell what the difference is, but it seemed like a stronger machine that produced a much more detailed picture of Audrey's insides and all. Again, the point was to look for signs of something being wrong that would explain that would explain the test result. Well, it was instantly apparent what the cause was. In addition to a mistaken due date and actual birth defects, one of the reasons that test can produce non-normal results is if there is more baby in the womb than you were expecting when you took the test. That's right...the test was done with one baby in mind, but the sonogram clearly showed two! We were totally floored. Suddenly, at 18 weeks pregnant, we found out we were having identical twins. I think my jaw hit the floor. Audrey and I just kept looking at each other in disbelief. Never in our wildest dreams did we even consider this as a possibility. Before you ask, no it doesn't run in our families. Besides, there is no genetic predisposition for identical twins. Identicals are just a random fluke of nature - the cells split at just the right time and you get two matching sets of cells, each with the exact same DNA and each set independently growing into a human being.

We giggled and held hands and just tried to integrate what this all would mean for us. Twin infants means big, big change is coming and we hadn't planned for that degree of change, of course. Is the house big enough? Where do they sleep? Can we fit all the kids in the car? How will we get through the first few months? All sorts of questions popped up. But, the story isn't over yet.

So, after identifying that we are having twins, the sonographer starts looking for the membrane between them. I'm no expert, but there are a number of different configurations for twins. There are fraternal twins, which are two eggs and two sperm and nothing shared between them, including different placentas and all that. Then there are identical twins which can have varying degrees of shared stuff. In our case, the twins are sharing just about everything. They share both the outer and inner sac, otherwise known as monoamniotic twins. This means that there is nothing keeping them from touching each other or from swimming around each other, tangling up the umbilical cords and cutting off their own blood supply. And that is where the issue lies. There is some risk of the babies doing exactly that or of tangling the cords and compressing them at some point in their growth. And, cord entanglement could result in the babies not making it.

What does this all mean? We are having twins, but this is a high risk pregnancy. Up until 24 weeks, babies just aren't viable outside of the womb. So, until we hit that point, there is nothing we can do other than tell these two kids to play nice in there. At 24 weeks, Audrey will likely be admitted to the hospital and basically put on bedrest for the remainder of the pregnancy. The reason for this is that she can be monitored regularly in the hospital, or rather the babies can be monitored, and the doctors can do a c-section in the case that there are signs that something is wrong. The babies would then be kept in the NICU until they were healthy enough to come home. If all goes well, they don't come out until 34 weeks or more and won't be that premature. Then, they will probably only need a few days in the hospital. Earlier than that and they'll need some degree of care and monitoring.

No matter what happens, this is clearly going to have a big impact on our family. Hospital stay, twins, potential risks and complications...it has been a lot for us to digest and deal with. But we are in good spirits and holding up well so far. Whatever happens, happens, but we are very hopeful that everyone involved comes out fine at the end. And, we know right now that we have two healthy babies, so we are planning for their impending arrival.

We will soon be a family of five. Wow.

1 comment:

Anonymous said...

The Walshes' best wishes are with you, Audrey and Noah! Let us know if you need anything. Take care and keep us posted.