TTMA MFM Specialists *Update in comments. TW*

[lucylou]

Hello. I intro'ed freaking out a few weeks ago about possible twins (early ultrasound showed 2 gestational sacs). My follow-up appointment is Tuesday and if we find 2 heartbeats, I want to be prepared.

I had never really heard of MFMs until I stalked these threads. I googled my area to see if maybe my OB happened to be one, and the only listings I could find were at a different hospital in the area. Is it possible the hospital my doctor delivers at doesn't employ them, or is it a pretty standard position anywhere you go? The hospital does deliver from 33 weeks and has a whole page about multiples on their website (if that helps).

I guess my questions are, will I automatically be referred to one if having multiples? If not, should I request it? What all do they do that a regular OB does not? I had high blood pressure with my DS and was monitored very closely the last month or so with him when it was up. If my doctor tries to assure me they can handle multiples on their own, I want to know if I should insist otherwise.
Thank you in advance! I'll be sure to update you all on how the appointment goes.

[lastkiss]

I'm not sure what the standard is but where I am we don't have MFMs in our city. They're 2 hours away so women are only referred if they're high risk.

My pregnancy (di di) has not been complicated so far so there's been no need to refer to me to one. I meet with my OB more frequently then I did with my singleton pregnancy and will have more ultrasounds to ensure there's no growth issues etc.
If something comes up, I'll get referred then.

[therealbug]

I see an MFM because I'm high risk due to my age and previous PTL at 20 weeks. Twins are an additional high risk factor for me.

Where I'm at, my OB is primary with the MFM consulting. I see each every four weeks.

One of my big concerns with my OB was their experience with twins. I went in for my initial consult with some deal breaker questions. For example, if they had told me to gain the same as for a singleton or eat only a couple hundred calories more per day, that would have been a red flag for me.

[dukegirlsc]

I am considered high risk due to age and the twins. I have been seeing a MFM since week 12. My OB is primary with MFM consulting. A good way to look at it is that the OB primarily takes care of you, the MFM focuses on the babies. I have all my scans with the MFM and my OB gets their reports. I saw both every 4 weeks until 24 weeks when I started seeing the OB every 2 MFM every 4. The MFM/perinatolgist is more trained to deal with high risk pregnancy. You say that your hospital delivers from 33 weeks on, which probably means they have a level 2 nursery. I would find out where they would be delivered if they come before 32 weeks, that is probably where you will find a MFM. I hope your appointment goes well on Tuesday!

[Squishy622]

I only saw a MFM because my twins were mono-di (shared a placenta). Regular OBs are usually very well equipped to care for a low risk twin pregnancy. Good luck, hope all goes well with your pregnancy!

[lucylou]

Thank you ladies! I really appreciate the guidance

[schmella]

I transferred directly from my RE to an MFM group exclusively at 8 weeks, but I was high risk due to selective reduction to twins. Because of my risk factors I was treated as AMA, and I had quite a few complications that were not handled well by the OBs on call at the hospital. That said, the higher level NICU was also the closest hospital for me.

If you have no other risk factors other than twins, and there is no MFM close by, you'll probably be fine. But for peace of mind, you might consider getting an appointment with the nearest MFM (so that, god forbid, you NEED to see a specialist, you are already a patient! And because they are generally better trained and/or have better equipment to catch something concerning early). I would also discuss (with your OB) what the plan for early or preterm labor would be- what hospital would you go to, how would they get you there. What happens if you need a higher level NICU after a c/s- most often they will transfer the baby(ies) but you will have to recover in a different hospital. If your OB doesn't have a plan or blows off your questions or concerns, that would be a red flag to me. Again, you'll probably never need most of these things but its good to know ahead of time.

[piccyami]

My OB referred me to an MFM in their building for a consult (standard practice). Their ultrasound machines were better quality and my OB trusted MFM measurements over her own techs. I continued to go to them (3 weeks in the beginning, every week in the end) because of the growth discordance, then my pre-e. The MFM was actually the one that sent me to the hospital to deliver because of my pre-e.

[Crisco Salad]

With my OB, seeing an MFM was not the standard. I was referred because of a history of short cervix which they check every two weeks until I get to 24 weeks. If I didn't have a history, I would have seen them only toward the end of my pregnancy for growth scans.

[lucylou]

Well turns out I was getting ahead of myself. We have a healthy baby A, but baby B stopped growing sometime 2 weeks ago (measured 7+5). My doctor said since they had their own placentas, it shouldn't have an effect on baby A. I hope she's right.
I want to thank you all for the support the last few weeks and I wish you all the best!

[dukegirlsc]

lucylou, I am sorry for your loss. Best of luck to you for a happy and healthy 9 months. 

[callmeKD]

Sorry for your loss lucylou. I hope baby A continues to be healthy!

[Crisco Salad]

I'm so sorry for your loss lucylou

[bocaburger]

I'm very sorry for your loss.

[lastkiss]

I'm so sorry lucylou. Be kind to yourself and fx you have a healthy rest of pregnancy with Baby A

[DVMmomma]

Bummer lucylou! Would have been fun to have you here but I'm glad you have a healthy baby A so far!! Best of luck in the coming months!

[lindsay]

So sorry for your loss. I hope the rest of the pregnancy goes well for you.

[lotusbee]

Sorry to hear of your loss lucylou! Wishing you and Baby A healthy rest of your pregnancy.

[Deleted]

So sorry for the loss of your Baby B, but my best wishes for a happy and healthy pregnancy with Baby A.

[therealbug]

So sorry for your loss of Baby B. Wishing you and Baby A a healthy rest of your pregnancy.

[pbandj714]

I'm so sorry for your loss lucylou. Take care, and I wish you and Baby A the best for the remainder of your pregnancy!

[dashuria]

lucylou, I'm very sorry for your loss. I hope Baby A continues to grow healthy and strong! (Maybe you can find some comfort in this...my previous pregnancy we also lost Baby B around 10wks. Our Baby A continued to grow and we had no complications. He is a healthy 16month old now. I know its hard but try not to worry too much. Hugs!)

[lucylou]

Feb 23, 2017 14:09:32 GMT -5 dashuria said:

lucylou, I'm very sorry for your loss. I hope Baby A continues to grow healthy and strong! (Maybe you can find some comfort in this...my previous pregnancy we also lost Baby B around 10wks. Our Baby A continued to grow and we had no complications. He is a healthy 16month old now. I know its hard but try not to worry too much. Hugs!)

That does help, thank you. It's hard not to worry when you know something has already went so terribly wrong.

[lucylou]

Thank you for all the kind words, everyone.

[requiressnacks]

I am so sorry for your loss lucy.

[Deleted]

So sorry for your loss lucylou.