Morning sickness was symptom of rare twin pregnancy

Lex is an immigration legal professional who lives in Florida along with her husband and her twin boys. Although she initially shared the story of her high-risk pregnancy on TikTok in March 2021, her most up-to-date mono mono twin video took her story to new heights.

Lex’s mono mono twins ultrasound

In December 2018, Lex discovered she was pregnant. It was a shock given her preexisting situations, which may have an effect on fertility. “I had been told that it would be very difficult to get pregnant because I have PCOS, polycystic ovary syndrome and factor V, which is a blood clotting disorder,” Lex instructed TODAY. She and her husband have been elated to expect. 

Lex had her first ultrasound appointment at six weeks. On the scan, it was clear that there was one yolk sac, which gives the embryo vitamins throughout early pregnancy till the placenta types. “There appeared to be one baby,” Lex recalled. Her physician was shocked by the robust cardiac exercise she heard, however as a result of the whole lot else appeared regular, it was chalked it as much as a wholesome pregnancy.

One week later, about seven weeks alongside in her pregnancy, Lex awakened with debilitating morning sickness. “I couldn’t get out of bed. I couldn’t eat or drink water,” she stated. It would not go away, and it turned out she was affected by hyperemesis gravidarum, extreme and chronic nausea and vomiting throughout pregnancy.

Lex’s OB-GYN prescribed her medicine and requested her to choose it up in-person on the clinic so they may check out her simply in case. Anticipating a brief and uneventful appointment, Lex instructed her husband he didn’t want to hitch and will head to work. Spoiler alert: He by no means missed one other appointment after this one.

When she arrived on the clinic, Lex stated her OB-GYN was alarmed by how sick she seemed and requested to do a fast ultrasound to verify the whole lot was OK. That’s when issues took a flip that neither Lex, nor her OB-GYN, had ever anticipated.

“The ultrasound was taking a very long time,” Lex stated. After a couple of minutes, the OB-GYN requested Lex if she knew that she was having twins. “I said, ‘No, I’m not because I had just been there the week before and I have one yolk sac.’ … And she said, ‘Yes, you are,’” Lex recalled. The OB-GYN then confirmed her the ultrasound, which Lex stated seemed like two little beans with flickering spots within the middle.

The robust cardiac exercise detected at six weeks was truly from two embryos proper on high of one another.

Lex skilled a spread of feelings — from feeling unprepared to be a mother of two at 26 to grateful to be pregnant with twins after expecting fertility issues. But then her OB-GYN went quiet and saved shifting the ultrasound probe round her stomach. “I noticed they were so close together, so I asked if they were conjoined, and she said they might be,” Lex stated.

Not solely was Lex alone, however she had additionally forgotten her cellphone so she was unable to succeed in her husband. “I was freaked out. It felt like a bad dream,” she stated. Her OB-GYN then known as in an ultrasound technician to have a look, who instructed Lex that based mostly on how shut they’re, the twins have been almost certainly both mono mono or conjoined. 

Lex had by no means heard of mono mono twins earlier than. “I asked my OB-GYN how many times she had seen this, and she said never,” Lex stated. It was fairly actually one thing out of a medical textbook.

What are mono mono twins?

Monoamniotic-monochorionic twins are equivalent twins who’re in the identical amniotic sac and share a placenta, Dr. Mauro Schenone, board-certified maternal fetal medication specialist on the Mayo Clinic in Minnesota, who didn’t deal with Lex, instructed TODAY.

“We categorize twins by zygosity, so whether or not they come from the same fertilized egg,” Schenone stated. Monozygotic, aka equivalent twins, happen when a fertilized egg splits in two, and dizygotic, aka fraternal twins, come from two separate, fertilized eggs. Then, there are three extra classes of twins, stated Schenone.

Dichorionic-Diamniotic (Di-Di): Each twin has their very own amniotic sac and their very own placenta, identical to a singleton child. These will be both fraternal or equivalent.

Monochorionic-Diamniotic (Mono-Di): Each twin has their very own amniotic sac, however they share the placenta. This is simply doable with equivalent twins.

Monochorionic-Monoamniotic (Mono-Mono): Both twins share the identical amniotic sac and the identical placenta. These twins are at all times equivalent and will be conjoined. This is the rarest, making up lower than .1% of all pregnancies, according to Columbia University.

How do equivalent twins find yourself in these completely different configurations? The concept is it depends upon what number of days after fertilization the fertilized egg splits, Schenone defined.

“If they split within the first three days, you end up with two placentas and two sacs (di-di). If they split between day four and eight, then you have one placenta and two sacs (mono-di). If they split between day eight and 12, they will share a placenta and a sac (mono-mono),” Schenone stated. If the egg splits after 13 days, you possibly can find yourself with conjoined twins, he added.

Most research estimate that, of the mono mono twins that make it to the second trimester, 12 to 23% will die in the course of the the rest of the pregnancy or first month of life, Schenone stated.

The commonest trigger of demise in mono mono twins is umbilical twine entanglement. As Lex was instructed by her medical doctors, it will possibly occur at any level throughout a mono mono pregnancy up till the day of beginning.

Early care and monitoring enhance the probabilities of mono mono twins’ survival. Most sufferers pregnant with mono mono twins will probably be hospitalized by the point they hit 28 weeks, which helps forestall twine entanglement. Mono mono twins are often delivered between 32 and 34 weeks and at all times by Cesarean part as a result of of the danger of twine entanglement throughout beginning, Schenone stated.

“Only a 50% chance we’ll make it past 12 weeks”

All conjoined twins are mono mono, however not all mono mono twins are conjoined. So at that very same appointment, Lex underwent a sort of ultrasound that makes use of sound waves to evaluate blood circulation within the fetus. “There (was) very much two separate blood flows,” Lex stated, which indicated the embryos weren’t conjoined. But it was too early to make certain. She needed to wait till her 14-week ultrasound to substantiate the twins have been mono mono however not conjoined.

“Then (the doctor) gives the kicker: There’s only a 50% chance we’ll make it to 12 weeks,” Lex stated.

“I couldn’t see a maternal-fetal medicine specialist before 14 weeks because there’s nothing really they could do,” Lex said. In the meantime, her OB-GYN asked her to come in every week for what’s called a “demise verify” to make sure the babies were still alive.

“I was very depressed,” Lex said.

She made it past 14 weeks, at which point doctors confirmed it was a mono mono pregnancy and she was having boys. Thanks to her therapist, her mental health had also improved by that time.

“If you can get therapy, get it because that made a world of a difference and helped me reframe things,” she stated. “It also helps that my husband is just an uncannily positive person.”

“High-risk pregnancies take your plan and vision completely out of your hands,” she added.

Lex distracted herself for the remainder of her pregnancy before being hospitalized by studying for the Florida state bar exam. She also joined a mono mono mom Facebook group, where she could ask questions and share her experiences with about 2,000 other moms who went through the same thing.

At 22 weeks, Lex had an early baby shower, but she said it took some convincing on her husband’s part. “When you have a high-risk pregnancy, it’s very scary to celebrate the milestones,” she explained.

At 25 weeks, Lex was admitted to Tampa General Hospital, where she was monitored day and night by a team of maternal-fetal medicine specialists, OB-GYNs, residents and nurses.

“There (was) a little machine next to me where I (could) hear their heartbeats, which (was) very comforting and warm,” she recalled.

Lex spent most of her time resting, strolling across the ward or treating herself with a visit to the hospital Starbucks if the twins have been doing nicely. She acquired recommendation on find out how to keep sane and relieve again aches from the mono mono mother Facebook group.

Other than two “twin demise” scares, the place one child was hiding behind the opposite so the monitor didn’t choose up a heartbeat, Lex stated the pregnancy was uneventful — apart from one different second.

Just a few weeks earlier than her scheduled C-section date, she realized she handed the bar, which she took earlier than being admitted to the hospital. So she acquired dressed up and had the swearing-in ceremony from her hospital room. “I got sworn in as an attorney in the maternity ward, which I think is pretty rad,” she quipped.

At 32 weeks, she went in for her deliberate C-section. “There was just a sense of elation in the air, like we made it,” Lex recalled. Greeting Lex within the working room was her favourite group of suppliers.

On May 16, 2019, Lex gave beginning to 2 wholesome, screaming child boys inside 15 seconds of each other. “They had an Apgar score of nine out of 10, so they were fabulous,” stated Lex. After the twins spent 30 days within the neonatal intensive care unit coaching their suck–swallow–breathe reflexes, Lex and her husband have been in a position to take their mono-mono twins house.

“Once they are out and healthy, the mono mono part of it is not relevant anymore,” Lex stated. Her sons are simply blissful, wholesome 3-year-olds.

There aren’t any telltale signs of a mono mono twin pregnancy, however there are some early indicators which will counsel a twin pregnancy. Hyperemesis gravidarus, the extreme morning sickness Lex had, “is more common in women who are pregnant with twins or more,” in line with Stanford Children’s Health.

Schenone advises sufferers pregnant with twins begin prenatal care as quickly as doable and be proactive. “Ask your providers: Do my twins share either the placenta or an amniotic sac? Because again, these are managed very differently,” he stated.

Lex, who has related by social media with many anticipating twin mothers feeling scared or alone, additionally provided some recommendation: “Stay off Google, get a therapist if you’re able to, and to try to stay as positive as possible.”

Reach out to your main care supplier or OB-GYN when you’ve got any questions on your particular person pregnancy.