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Discusses Women's Health

Ten days ago my daughter had an emergency C-section at 32 weeks for her identical twins. I grabbed a flight and flew to Tel Aviv and will remain here until the end of the month. Since this is a women’s health website, let me provide a quick medical synopsis on identical twin pregnancies… They are the result of a division of a fertilized egg several days after it begins to develop. Depending on how early that division occurs there can be two complete placentas and two inner amnio sacs with two outer chorion sacs or if a bit later just one placenta. If there is one placenta, the embryos usually have their own inner amniotic sac (biamniotic) but share an outer chorion (monochorionic). Less commonly they can share one amnion (monoamniotic). In the latter case their umbilical cords can wrap around each other and complications are more likely to occur. My daughter’s pregnancy was monochorionic and biamniotic. In this type of twinning, as the babies grow, the placenta may not give each the same amount of nutrients. After the second trimester, the growth of the babies, the width of their umbilical cords to each baby and the flow within them was measured weekly with ultrasound. If one baby gets too much flow from the placenta it can strain its heart. If the other gets too little it doesn’t thrive and can become anemic. This is called twin to twin transfusion. At 32 weeks this began to happen to my daughter’s twin boys and hence she had an emergency C section. They are now in separate incubators in the NICU and appear to be doing well, and will be there until they are 36 weeks old. She is diligently pumping breast milk, she and her husband are “kangarooing” (holding the babies skin to skin to reassure and sooth them) and I am providing emotional support (with occasional medical suggestions. The premature baby care here is world class!)

Hence my absence from the practice and I apologize to those whose appointments were cancelled. And hence, last week’s absence of my Friday website article. I plan to continue with reports on studies and women’s health issues next week. And I will keep you posted on the babies!

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