Middle Pregnancy: Testing...Tesing,...1,2,3!

The positive pregnancy test is only the beginning. One thing that comes along with pregnancy - and especially twin pregnancy - are tests. Some tests you may need, and others you may want to forgo. This page is a good reference from the Mayo clinic. Here is our 'test' voyage.

Early Pregnancy Tests

Because I conceived naturally, I did not have the hCG screenings that many do in early pregnancy. What I have seen from others is that hCG levels are not always consistent with what providers expect for M.O.M.s.  So don’t get your undies in a bunch if your levels aren’t rising ‘as expected’. Every woman, and every pregnancy are different!

Ultrasound

I always laugh when I see a fictional movie or TV show where a twin mom with no showing belly says ‘The doctor found two heartbeats! I’m having twins!’. Unless you are very far along in your pregnancy, AND your doctor is actively looking for two, AND your babies have the right positioning, AND your babies’ have very different heart rates – It WON’T HAPPEN THIS WAY. Even in my late pregnancy appointments when my doctor was searching for two heartbeats with a Doppler, we had trouble being certain that we were in fact finding two distinct heartbeats. But maybe there is someone out there who discovered she was having twins because they detected two heartbeats…if that’s you, I’d LOVE to hear your story!

My twins were diagnosed by ultrasound, as are the vast majority. But what if you don’t have an ultrasound right away? Many women wonder what they will find at their 20 week ultrasound. But if you just can’t wait, here are some reasons you should request your doctor send you for a ultrasound: You were taking fertility drugs, Your middle is growing more quickly than what is normal for gestational age (your doctor will monitor for this), twins tend to run in your family, and you’ve previously given birth to twins (yes, this means you too identical twin moms!). If any of these apply to you – you should ask your doctor about getting an ultrasound!

Although it isn’t the most exciting part of an ultrasound, there are a few important ‘other’ things that will be determined at your first ultrasound (well, your second one, after you know you are having multiples). They will attempt to determine whether your babies are sharing a sac or have each their own and also determine if they are sharing a placenta. Of course, ultrasound is also good because it can detect several abnormalities like heart problems thay may need treatment soon after birth. Later in pregnancy, ultrasound is used to make sure that the babies are growing at approximately the same rate and to monitor for intrauterine growth restriction or Twin to twin transfusion syndrome. 

Blood Glucose Test

This test is often done mid-way through your pregnancy to screen for gestational diabetes. There are some women who are normally healthy, but during pregnancy contract diabetes, and after pregnancy are healthy again. The test usually means drinking an orange-soda-like drink beverage and having blood drawn an hour later. If you do ‘fail’ this test..don’t worry. You will still pass the motherhood exam! Only a small percentage (about 15%) of people who fail it actually have gestational diabetes. But you will have to go back for another, more intensive test to find out. -one that involves drinking more orange soda over a longer period of time (if only it was GOOD orange soda!)

Blood Tests

No doubt your blood will be drawn at least a few times. Early on perhaps to test your immunity to certain diseases that can be dangerous to your babies if you contracted it while you were pregnant. They may occasionally monitor your levels of all kinds of things like platelet count, Strep B and blood glucose levels. I think someone could write a book on all the possibilities, so I’ll stop here in favor of providing a few links.

Urine Screening

I always promised myself I would write a stand-up comedy routine about being pregnant with twins. It would include a reference to the weekly attempts to make a ‘clean catch’ with a beach ball strapped to your belly! I had to do a pee test every time I had an appointment.  They generally screen for protein and sugar in your urine and other signs of preeclampsia or toxemia.

Amniocentesis

With this test, a needle is used to draw amniotic fluid (while monitoring via ultrasounds to make sure nothing gets unintentionally poked! Ikes!) from one or more of the babies’ amniotic sacs. It is basically a genetic test and is often done to further investigate results of a previous screening, especially chromosomal abnormalities or a whole slew of diseases or defects.

This test has a 1/200 chances of causing miscarriage or premature labor because it pierces the amniotic sac. Apparently the risk is greater earlier in pregnancy. If your physician recommends amniocentesis, make sure you understand the reasons for it and agree it is worth the risk. I once talked to a M.O.M. who had this test and had no clue why. It is SO important to be involved in your care and always know exactly what is being done and why.

Chorionic Villus Sampling

This test is actually kind of similar to Amniocenteses. The main difference is that instead of removing fluid from inside the baby’s amniotic sac, it is removed from outside the chorionic sac of tissue. It can diagnose a multitude of fetal diseases.

Our choice in which tests to do was quite simple. If the test could reveal a problem we could actually seek treatment for, we would do it. We knew that we could never bring ourselves to terminate, no matter the problem, and didn’t see any reason to do tests that would cause anxiety over something we can do nothing about. If there was some sort of problem, I would rather go on enjoying my pregnancy and basking in the joy of it rather than stressing over what may or may not be wrong. My doctor didn’t wrestle me on the decision and said that with the many ultrasounds done on twins they would probably pick up on most problems anyway. We forwent the genetic testing and only had ultrasounds and standard maternal urine and blood glucose and screening test.

One thing to be aware of is that your insurance may not cover some of the genetic tests. Make sure you call your insurance company and get pre-approved for genetic tests so you don’t get stuck with an unexpected bill!