do i need to see a specialist if i am carrying twins?

[Anonymous]

hello, i'm 5 weeks, and will have a sonogram on monday. it's possible i am carrying twins, (i had 2 5 day embryos transferred). my friend told me that if i am carrying twins that i would need to see a specialist for my prenatal care, and not just a "regular ob/gyn".

true story?

[Anonymous]

not true. I saw a regular ob/gyn and had a perinatologist consult just so that if something went wrong with my pregnancy we had a high-risk doctor on-board that knew me and my case. IN the end, I did need the high risk doc's input on my care, but my OB still delivered my twins. This question seems premature considering you haven't even had your first u/s. I wouldn't worry about any of that just yet.

Congrats on your pregnancy.

[Anonymous]

Are you otherwise high risk? If not, then your regular OB is fine. Twins are common.

[Anonymous]

I have miscarried before, but i don't know if that makes me "high risk". As for "premature", I will find out in a few days and so why not ask now about it? I just got worried & I feel like it takes time to get appointments with specialists also, so why not be somewhat prepared? It is also open enrollment for us and we are trying to decide what the best option is for us.

Anyway that's a good idea to have one "on board".

[Anonymous]

I am carrying twins and am seeing my regular Obgyn. They have sent me off to get sonograms every 4 weeks. When I was carrying my singleton several years ago, I believe I only had two or three sonograms the entire pregnancy. I dont know if the increased number of sonograms is because of the twin situation or because I am high risk (old), or both. In any case, I am seeing my regular OBGYN. Congrats and I hope all goes well!

[Anonymous]

I have 18 month old twins. You can keep your regular OB. You should know that there is a HUGE range of how doctors treat twin pregnancies. Some treat it like a regular pregnancy until a problem arises. Some are extremely conservative from day one. At the most extreme end, some doctors prescribe bedrest as a matter of course.

If you are having twins, I would recommend joining the MD or VA Parents of Multiples groups so you have a knowledgeable, supportive network. I would also read Dr. Luke's book on multiple pregnancies. Bottom line: get informed and decide how conservative you want to be. If your doctor can support your approach and you trust him/her, stick with it. If not, consider switching.

Personally, I had a doctor I was very happy with, but she only delivered at Sibley. I decided to deliver at Georgetown because 1) they have the best NICU around and 2) if I went into labor before 34 weeks (very likely with twins) Sibley would have sent me to Georgetown anyway. The second practice I went to is highly regarded, but they had a very nonchalant attitude about twins and kept pushing me to have a c-section. I finally switched to Georgetown's high-risk practice and, although the three specialists there have some bedside manner issues, I was 100% confident in their abilities and I was able to relax and enjoy a relatively easy twin pregnancy.

Good luck. And don't be too freaked out. Twins are harder in some ways but they are also a real joy.

[Anonymous]

thank you so much! that's a lot of great information.
hopefully we'll know more on monday!

[Anonymous]

please keep us posted OP!

[Anonymous]

It /may/ depend on what kind of twins they are. A pregnancy with fraternal twins is much less riskier than one with identical twins, especially if they share a placenta and especially if they share a sac (no amniotic membrane) - risk of things like twin twin transfusion. I am pregnant with identical twins - one placenta (mono chorionic) but separate sacs (di amniotic) so I have chosen to go the high risk OB route. I may have felt differently if I was pregnant with fraternal twins.

[Anonymous]

I agree with 16:43 poster. I had fraternal twins and I saw my regular OB, who had me consult with the high risk OB group for some of my testing. Everything went great with my pregnancy -- I went into labor on my own at full term and my regular OB delivered the twins.

If I was a pregnant with identical twins, especially ones sharing a sac, then I would sign on with a high risk OB.

[Anonymous]

I had fraternal twins as well and saw a regular OB practice. I was monitored closely and never needed to see a high risk specialist.

I think most high-volume OB groups (basically any in this area) are more than capable of caring for a normal fraternal twin pregnancy. They will refer you to a high risk specialist as needed. There is a very high concentration of twins in the area (older moms, lots of fertility clinics) so twins are incredibly common and something that I would imagine most if not all OBs around here have managed many, many times.

I agree with the previous poster that if you have identical twins, esp. those sharing a sac then you should see a maternal-fetal medicine specialist from the beginning. However, I imagine this is not too likely given that you tranfered two blasts (although certainly one could split!)

Congratulations on your pregnancy!

[Anonymous]

OP I would see either a MFM specialist or at laeast a practice that has a very integrated MFM on board. Oddly, MFM can sometimes be more supportive of vaginal birth as they see multiples and high risk situations all the time. If I didn't want an automatic c-section then I would find someone who has a track record with delivering twins vaginally. Since these are usually (not always) c-sections now I would want someone with experience.

While twins are common this doesn't mean they are not high risk. With twins your risks for certain complications such as preterm birth or preeclampsia does increase and while generalists see this, MFM are better prepared to track and respond to these conditions. I would not deliver twins at Sibley as they have a lessor NICU. Many twins are born after 35 weeks and need no to little NICU time, I would want a staff on site that is prepared for anything not transport to another hospital.

[Anonymous]

op here - wow thanks for the responses! keep 'em coming. this will all be helpful in deciding.
found out this AM - IDENTICAL twins! either singleton or fraternal was def. on our radar, but idential - never in a million years. both measured fine, and saw both heartbeats. 6 weeks now, and have to go back in 2 weeks (ugh another 2ww) to be sure everything is still OK, and that 2 amniotic sacs are forming, or have formed....
i just pray that we get through the next 2 weeks.

thanks again!!

[Anonymous]

Wow! Congratulations on your identical twins! NP here with 1 yo. fraternal twins. Since there is a higher risk for carrying identicals, perhaps you could consider an OB who delivers at a hospital with higher level NICU (at least Level III). My regular OB told me if our twins were born before 34 wks of gestation, then we would have had to go to G'town, WITH ONE OF THE G'TOWN DOCS, for the higher level NICU. We ended up delivering at Sibley with our reg OB.

Best of luck to you and I wish you a healthy and joyous pregnancy

[Anonymous]

thank you! which hospitals have higher level NICUs? we live in arlington, currently am a patient at Arlington Women Center...
Also, I know it is still early, but any specialist recommendations would be great too. i don't even know where to begin...