#PregnancyLoss #Guilt #TwinPregnancy #NEC #Stillbirth #PrenatalDiagnosis #PregnancyComplications
πΆπ©βπ§βπ§ Losing a twin during pregnancy is an incredibly devastating experience. The grief, guilt, and fear can be overwhelming, especially when there are unanswered questions and concerns about the surviving twin’s health. It’s important to remember that you are not alone in this journey and that there is support and information available to help navigate through this difficult time. In this article, we will address the common questions and concerns related to losing a twin during pregnancy and provide valuable insights to help ease your worries.
##Understanding the Circumstances
###Medical Concerns and Prenatal Testing
The initial diagnosis of exomphalos and Single Umbilical Artery (SUA) for twin 1 might have prompted the recommendation for a Chorionic Villus Sampling (CVS) at 15 weeks. It’s important to understand that the CVS was a proactive step to identify any potential chromosome defects and did not cause the loss of twin 1.
###Stillbirth and Causes
The loss of twin 1 at 18 weeks might have left you questioning if there was something you could have done differently. It’s essential to recognize that stillbirths can occur due to various factors, including genetic abnormalities, placental issues, and other complications that are beyond your control.
##Coping with Guilt and Grief
###Acknowledging Emotions
The feelings of guilt and fear are natural responses to the loss of a twin during pregnancy. It’s okay to grieve and seek support from loved ones, counselors, or support groups who understand the intricacies of pregnancy loss.
###Forgiving Yourself
It’s crucial to recognize that you made decisions based on the information and recommendations provided by medical professionals. Be kind to yourself and acknowledge that you acted in the best interest of your twins.
##Addressing Concerns for the Surviving Twin
###Risk of Neurological and Developmental Problems
The fear of potential complications for the surviving twin is understandable. However, it’s essential to consult with your healthcare provider to understand the specific risks and monitoring that may be needed for the remainder of the pregnancy.
###Preventing Preterm Labor
The concern about going into premature labor is valid, and your healthcare team can provide guidance on monitoring and managing the pregnancy to reduce the risk of preterm birth.
##Seeking Support and Information
###Connecting with Others
Connecting with other parents who have experienced the loss of a twin during pregnancy can provide valuable insight and support. Online forums, support groups, and counseling services offer opportunities to share experiences and gain knowledge from those who have walked a similar path.
###Education and Advocacy
Seeking information and resources related to pregnancy loss, prenatal testing, and twin pregnancy can empower you to advocate for your needs and make informed decisions moving forward.
##Conclusion
Losing a twin during pregnancy is a heart-wrenching experience that prompts a wide range of emotions, questions, and concerns. It’s essential to recognize that the guilt and fear you’re experiencing are normal, and seeking support and information can help ease the burden. Remember that you are not alone, and there are resources and communities available to offer guidance and understanding as you navigate through this challenging journey. Your healthcare provider can offer personalized support and monitoring for the ongoing care of your surviving twin, helping you to feel reassured and informed as you move forward in your pregnancy.
First, I am so very sorry for your loss. I want you to know that **the death of your daughter is not your fault** regardless of the CVS testing. It is normal to feel guilty, but **you are not to blame.** Do not let anyone tell you otherwise. I am a pediatrician in the Neonatal Intensive Care Unit, so I deal with sick/tiny babies and frightened families all the time. I see how hard it is to ignore that mom-guilt, but I also know how important it is to show yourself grace and love so you can be the best possible mother for **both** your daughters.
Second, a few medical facts to answer your questions:
1. The risk of miscarriage after CVS in twins is somewhere between 0.5% and 1%. Due to the fact that CVS is typically offered when there is concern for increased risk of a genetic diagnosis, itβs really hard to determine whether the link between CVS and miscarriage is causal or just a correlation. Some recent studies suggest that very few miscarriages after CVS are actually related to the procedure itself. In the case of your daughter, exomphalos/omphalocele is highly associated with the presence of other abnormalities and often a sign of an underlying genetic condition. Normal genetic testing on CVS does not rule out the potential of a genetic diagnosis, as there are many different kinds of genetic testing and many different kinds of genetic diagnoses. Exomphalos is associated with increased risk of miscarriage even without the presence of other abnormalities. So, it is much more likely that your daughter passed due to her her underlying condition, and not the test.
2. The question of any risk to your other daughter would partially depend on what type of twins they are – do they share a placenta, an amniotic sac, neither? Not being identical does not completely answer this question. If they share a placenta, then the testing would have looked at their shared placenta, and they would both have the same theoretical risks from the procedure. That being said, most pregnancy loss after CVS occurs in the first few days-week after the test, so with being three weeks out a theoretical effect at this point is very very unlikely.
3. I did a quick literature search and see no evidence that being the twin of an infant who underwent CVS carries any neurological risk. There is some evidence that if twins share a placenta and one dies in utero, the surviving twin is more likely to have neuro-developmental impairment.