Insights from Professor Kypros Nicolaides; The only doctor I would trust with my own twin pregnancy.
As expecting parents, the journey of pregnancy is often filled with excitement, anticipation, and joy. The babies we hold in our womb are the most precious of cargo. However, when it comes to certain high-risk or what I like to call more vulnerable pregnancies, such as those involving monochorionic twins (twins that share a placenta) a vigilant approach to monitoring is advised and for good reason.
It makes sense to me that if you wish to engage with maternity services, private or NHS, and you know you are carrying twins and what kind of twins you may agree with additional monitoring. Why?
Because like anything precious and vulnerable, tentative steps may need to be taken giving consideration, reverence and respect, and doing all we can to protect it. By we I mean you, your lover, your family, your friends, your clinical team, the community and anyone who may be gaining financially in some way because you exist, your babies exist and your pregnancy exists.
Professor Nicolaides explains why this is important
What that protection looks like to you is, in my genuine heartfelt opinion, that all and any decisions you make are entirely your own to decide, and I will champion all and any. Of course there are very few times that even with good monitoring that an issue may not be found in a timely way or poor quality monitoring following poor guidelines performed by sonographers who do not have the expertise to identify an issue.
Contrary to popular belief I am incredibly pro-physiological vaginal birth, home births and even freebirth of twins, I also champion people who chose an elective caesarean; I simply recognise that people must make their own decisions with access to the best information and the best clinical care.
If you are aiming for a Vag-Badge then great just know sometimes due to a real clinical need in regard to you and your pregnancy, you may end up going home with a
Caesarean seal of approval and that is okay, because this isn’t a millennial prize for second place. The families I support know that no matter what decisions they make if it has has been informed. And there is no shame. They need to be reminded that once those babies are in their loving arms they smashed it. When I leave my twin clients my parting words are “you won!”
The day I accept that a pregnancy is equally difficult for singletons is the day I accept that “twins and multiples are a variation of normaI” but that would be as likely as a cold day in hell
Suffice to say, don’t hold out in hope, even if hell hath frozen over I reserve the right to choose.
Poor quality monitoring, gives way to the trope that “ultrasound is but a window in time, a snapshot and that really anything can happen.”
Unfortunately I have heard this from parents, clinicians and those offering holistic perinatal support. There is sufficient evidence to suggest that with “Good quality Monitoring” conditions like TTTS that affect 15%, TAPS that affects 3-5% or sFGR that affects 10-15% can be mitigated to reduce harm. With this in mind today, let's delve into the importance of monitoring in monochorionic twin pregnancies, drawing insights from the expertise of Professor Kypros Nicolaides, a leading authority in foetal medicine.
Professor Kypros Nicolaides, one of the daddies of prenatal screening and diagnosis, emphasises the critical role of monitoring in identifying and managing complications in monochorionic twin pregnancies. Through regular ultrasound scans and other advanced diagnostic techniques, healthcare providers can closely monitor the growth and development of each twin, as well as detect any signs of potential complications early on.
Early detection allows for timely interventions, which can significantly improve the outcomes for both babies. Professor Nicolaides advocates for a comprehensive monitoring protocol tailored to the specific needs of monochorionic twin pregnancies alongside the wants, wishes and clinically relevant information regarding the person he is caring for. This may include frequent ultrasound scans to assess growth, Doppler studies to evaluate blood flow dynamics, non-invasive tests and occasionally amniocentesis for assessing foetal wellbeing.
In addition to medical interventions, Professor Nicolaides emphasises something I consider equally important. Providing expectant parents with thorough information and support throughout the monitoring process. Understanding the risks and being actively involved in decision-making can empower parents and alleviate anxiety during what can be a challenging time.
Furthermore, Professor Nicolaides emphasises the significance of multidisciplinary care involving obstetricians, foetal medicine specialists, neonatologists, and other healthcare professionals working collaboratively while listening to the mother and family to optimise outcomes for all.
In conclusion, monitoring plays a pivotal role in ensuring the health and wellbeing of both the pregnant individual and babies in monochorionic twin pregnancies. By staying vigilant and proactive in monitoring for complications , healthcare providers can intervene early and improve outcomes. The insights and expertise of leaders in the field, such as Professor Kypros Nicolaides, continue to shape best practices in prenatal care, ultimately benefiting families worldwide.
There is an added surprise and that is the fact he has made available all you need to understand your own pregnancy which you can find on the FMF website. Alternatively you can find direct links to the twin relevant information on his website Here
If this the sheer number of tabs is not a glowing example of ADHD I do not know what is.
As Prof correctly states “the women often know more than the clinicians.” Prof is one in a million. He listens, he shows compassion and my goodness how I wish there were more Foetal Medicine Doctors with the same values and principles.
God Save The Greek.
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