sFGR… aka wtf?

Let’s get to it shall we?

There are been multiple occasions when one of my friends said they wanted twins and I, consequently, fell out of my chair.  I couldn’t believe my ears. Why in the world would you want two babies at once?! I low-key coined it “offspring dysphoria”. The amount of work that must take, the amount of money it would take, the strain on other relationships, the amount of sanity lost… all seemed like one big ol’ Nope to me.

And yet… here we are. ? (God and his sense of humor, amIright?)

Twins are already a lot to deal with. 

There is the shock… and it’s one of those shocks that causes a legitimate upheaval of life as you knew it.  

There is the planning… All parents scramble to get ready for a new arrival and it’s stressful. Multiply that by 2 and you have twin planning.

IRL: the look you get when it’s twins ?‍♀️ ?

There are alllllllll the pregnant belly comments…. Good lord. I know I’m huge.  Don’t look at me and say “When are you due? You look fat!” I don’t want you to tell me that, Karen from Kroger. ?? No Joke, #truestory. Everything in me wanted to tell her her weave looked like it was from the 80s and it was crooked, but I let it go cause Jesus, ya know?

Then there are the complications… this is where we are sitting right now. When people ask me when I’m due (“Oct. 20”), then look at my belly, after the awkward pause, all I want to say is “It’s complicated.” I’m at 22 weeks now, but let’s do the rewind wheel and take you back to our first scan.

We have identical girl twins that are categorized as monochorionic/diamniotic (Mo/Di twins). This means they share the same placenta but have separate sacs while in the womb. At about 14 weeks we got our first scare. Twin to Twin Transfusion Syndrome (TTTS).  Baby B had less fluid in her sac and was smaller. This was an immediate referral to Cincinnati Childrens Hospital with docs who specialized in this. Only a small percentage of mo/di twins get this diagnosis. 

A few days and a short trip later, we found out that the twins do not have TTTS. They were misdiagnosed. Baby B had something called Selective Fetal Growth Restriction (sFGR/ otherwise known as SIUGR), category 2. This is where there is restrictive blood flow to Baby B and sometimes, intermittent/absent blood flow causes pausing of the blood flow in all of the chords and vessels. At conception the babies were allotted an unequal share of the placenta so Baby B just isn’t getting what she needs. Babies need blood and nutrients from the placenta to, you know, live.  There was a large difference in baby size. Baby A was 260g. Baby B was 160g. This news wasn’t awesome. In fact when they told us our options, I was just stunned.

There are a few outcomes of sFGR in a nutshell:

  1. It can reverse on its own and both babies can get enough blood. We make it to 34-36 weeks and deliver two babies.
  2. Things stay the same and we try to deliver as close to 27-34 weeks as possible.
  3. Baby B moves to category 3. This is where there is reverse blood in her arteries and vessels. This cause both babies to be in distress.

If option 3 happens, we would have had a chord ablation surgery. Trying my best to avoid this. The surgery had a very high success rate of keeping the bigger twin alive. It would cut off some connections that Baby B needed to survive. So at that point we’d give Baby A to have a 93% chance to survive or risk losing them both.

I left the hospital that day thinking it was possible I would have to choose between my babies. Just pick one to live and let the other one fend for itself. Like that is a choice anyone should have to make. It was heavy.

To further the saga, I was told at the beginning of this that I had a uterine fibroid that was growing, and being watched, probably would have to take care of it after the babies were born. It was the size of my uterus. Spoiler alert: ? It is not a fibroid it is an ovarian cyst. (Probably a big reason this pregnancy has been so hard). The doctor in Cincinnati referred me out to an ovarian oncologist to have further tests done (it’s not cancerous). I could have it removed before the babies are born, in the 2nd trimester. Under normal circumstances, surgery is recommended when cysts reach they 10cm and this lovely lady was sitting pretty at 13cm. Obviously, this isn’t normal…

Like I said….. it’s complicated. ??

Consider this your Netflix cliffhanger. There is fire ? in my next post. 

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