My momo journey started on April Fool’s Day, 2009. I was very excited for my first OB appointment and couldn’t wait to see the baby! I hadn’t had too many pregnancy symptoms so I looked forward to seeing the baby on an ultrasound to make sure all was well. After filling out some forms and going over some basic pregnancy info we headed back to the exam/ultrasound room. The OB started the ultrasound and I asked him if the baby was ok and he said, “This one looks great, and so does this one!” We were in shock to say the least. I asked him if it was an April Fool’s Day joke and he said he wouldn’t joke about this. He then pulled out a sheet of paper and quickly drew a few diagrams saying that he didn’t see a dividing membrane between the twins and they were probably monoamniotic monochorionic (momo). I was very clueless about the different type of twins so all of the information was new and overwhelming.
The next few weeks were full of appointments, more ultrasounds, and more discouraging news. The twins were confirmed monoamniotic on a high resolution ultrasound. The next appointments brought up a Choroid Plexus Cyst, increased chance of Down Syndrome, and possible IUGR. We decided to go inpatient at 28 weeks. In the US the standard of care for most momo twins is to be admitted to a hospital between 24 and 28 weeks. Once admitted the twins are monitored closely for any signs of distress due to cord entanglement, cord compression, or placental sharing issues.
During the pregnancy I called the girls “Hope” and “Faith” and spent many hours praying for their safety. Hope, faith, and love were all we had during this time and every ultrasound I would hold my breath until I saw two beating hearts. I had weekly ultrasounds until 24 weeks ~ one with my local OB and one with the MFM practice where I would be admitted. I started outpatient monitoring at 24 weeks with 3 NSTs (non stress tests) a week. At 26 weeks I started daily NSTs at the local hospital. At my very last NST before I was scheduled to go inpatient my OB saw some decelerations in one of the girls that concerned him. He decided it would be best to admit me immediately for observation. I hadn’t finished packing my bags and was scheduled to spend my inpatient stay in another hospital… I distinctly remember my husband coming to drop off a toothbrush and a few other essentials for the night and then eating Chipotle while worrying what was going on with our babies… The next day we drove 3 hours to the hospital I was schedule to stay at and I was frustrated because it took them almost 2 hours to put me back on the monitors. My room was tiny and the nurses looked at me like I was crazy because I had brought several bags of clothes, snacks, and things to keep me entertained. I wanted turn around and run back home but knew staying in the hospital was the best thing I could do for the girls.
I was on 24/7 monitoring (2 heartrate monitors placed on my belly to pick up the girls heartrates) which was difficult but I wouldn’t have had it any other way. It gave me peace of mind to see my girls’ heartrates all the time and knowing if something started to go wrong it would be quickly caught. Being on 24/7 monitoring wasn’t good for sleeping though because I could only lay in a certain position to keep the monitors on and if the babies moved the monitors would have to move as well so there rarely was more than 2-3 hours of uninterrupted sleep! While in the hospital I learned to crochet (not very well though!), watched a lot of NCIS, tried to learn Chinese (didn’t get very far), and did a lot of reading. I could go for one 15 minute walk a day around the hospital floor (sometimes I even got to go outside to a little courtyard on the 6th floor) and another 15 minute break for a shower…
We decided to deliver at 34 weeks and scheduled the c-section (all momos are born via c-section due to being in the same sac and the danger of cords being entangled and/or wrapped around the other baby) with the MFM (high risk OB) that we liked the best. Shortly after scheduling the delivery both girls had big decels at 1am (heartrates dropped into the 60s). A nurse rushed into the room and told me to roll onto my side. This had happened before and a slight shift was good enough to try to pick up the heartrate again. This time however she rolled me a bit and said “No! All the way on your side.” This quickly alerted me that something serious was going on. I looked at at the monitors and saw both heartrates were in the 60s (should be in the 140s-160s). Fortunately both girls’ recovered and their heartrates came back up. I can’t even imagine what might have happened if I hadn’t been on continuous monitoring… I truly believe being inpatient saved my girls’ life. If I hadn’t been on the monitors they may have shifted on their own and their heartrates might have recovered while I was sleeping… but again, I don’t even like to think of what might have happened.
During rounds the next day the doctors said “today’s the day!” We were at 32 weeks exactly. Walking past the nurses station to the OR for the c-section was very emotional and I started crying. I was thankful that we made it to 32 weeks but still scared to delivery my little babies. Once in the OR the spinal was quickly administered and wasn’t that bad. I started shaking and just felt really uncomfortable once it took affect though but soon calmed down. The c-section definitely wasn’t pleasant. Some people say c-sections aren’t bad but I definitely thought it was uncomfortable and unpleasant. I wasn’t in pain but could feel lots of tugging and pulling. Baby A arrived 54 minutes after I walked into the OR and Baby B 3 minutes later. Hearing them cry brought tears of relief and joy to my eyes! I got to see both girls briefly before they were wheeled to the NICU. I spent the time in the recovery room throwing up into my little bucket and shaking uncontrollably. The nausea and shaking wore off a few hours after the c-section and I headed to the NICU to see the girls. Seeing them with numerous monitors with breathing support (CPAP) was hard but I was so relieved that they were here safely. Besides being small and needing breathing support, they were perfectly healthy which also was a huge relief because the ultrasounds had caused me to worry a lot about their health.
The NICU definitely was a rollercoaster with lots of ups and then downs but overall it wasn’t too bad. We knew they would be in the NICU once they were born and I was very thankful they were here safely and didn’t have any major medical issues. Baby A, “Hope” only needed brief breathing support and was soon breathing completely on her own. She only needed to stay in the NICU for a few bilirubin treatments (“tanning” lights) and to learn how to feed and grow. Baby B, “Faith” had more difficulties breathing and ended up on nasul canula for several weeks. She also had a PDA which required medication to close, had to have a blood transfusion, needed bili lights a few times, and had lots of “As and Bs” (apneas and bradycardias), as well as learning to feed. We were in the NICU for 5 and 6 weeks and then finally headed home!
My girls are now two and are doing wonderfully!! They are tall for their age, love to give hugs and kisses, and are such incredible joys. They run, jump, laugh, and throw tantrums just like any other two year old! We couldn’t be more blessed and thankful for our momo miracles! It’s amazing how far they’ve come in such a short time. Watching them grow together and seeing the incredible bond they have has been the greatest gift.
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