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Ask Dr Ted Manos Your Own Question
Dr Ted Manos
Dr Ted Manos, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 343
Experience:  40 years experience; Board certified Ob-Gyn
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I am 7 weeks pregnant with fraternal twins and am very

Customer Question

I am 7 weeks pregnant with fraternal twins and am very confused by what I am reading and what my doctor is saying about Twin B. Twin A is dating exactly to correct size of gestation and has a heart beat of 128 BPM. Twin B however is dating 5 days behind and I am being told that this Twin may possibly not make it. Twin B has a heart rate of 99 BPM and I have read that this is within range. Could something be wrong with Twin B? And if I lose one twin what happens to my other baby? Very scared please ease my mind.
Submitted: 1 month ago.
Category: OB GYN
Expert:  Dr Ted Manos replied 1 month ago.
Hello, I'm Dr Manos, M.D., board certified ObGyn. At 7 weeks, seeing two separate sacs and the fetal heart flicker (heartbeat) is enough and too early to distinguish more than that. If something is not right with twin B and you lose him or her, twin A continues on and remnants of B get to be part of the tissues surrounding the amniotic sac. Twin A should be fine in this worst case scenario. Keep the faith and hope at this point. A repeat ultrasound in 10 days or so will shed more light on the situation. I hope my comments help your anxiety.
Customer: replied 1 month ago.
Thank you Dr. Manos. Her is a little more history. I just found out that I was pregnant on September 29. Twin A had a heart beat at 5wks and 6 days. Twin B was thought by my doctor that it was just an empty sac. Well Tuesday of this week October 4th my doctor scheduled me for another scan and low and behold Twin B had a yolk sac and a heartbeat. So now here we are at Thursday October 6th where he is now telling me that Twin B still may not make it bc his little sac is smaller than Twin A sac. He is starting to alarm me and I may switch doctors. I have no pain or bleeding. He never said anything about my baby's heartbeat as he didn't even read the report that was sent from the radiologist on Tuesday and he found out from me that there was even a heartbeat. I don't think you tell a pregnant woman that something is wrong this early on in my opinion!! He has scared me into tears to no end. So from all that I have explained this is pretty common for Twins?
Customer: replied 1 month ago.
Also will I expel Twin B? I am afraid that is my cervix opens which it has been told to me that it is shut that I will contract and maybe lose both my babies. This is my worst fear.
Expert:  Dr Ted Manos replied 1 month ago.
As I said before, if twin B doesn't survive, it wouldn't be expelled but will atrophy and be a small smudge in the membranes of twin A at term and delivery. It's common to see disparities between twin gestations but at this point be patient although it's tough to do. Heartbeats in first trimester are around 100 bpm or higher.
Expert:  Dr Ted Manos replied 1 month ago.
It's possible that we have two fertilizations days apart which can explain the disparity.
Customer: replied 1 month ago.
they were implanted it is believed days apart bc I ovulated from both ovaries as they saw corpus leuteum on both ovaries so it is believed its two different eggs that were fertilized!
Customer: replied 1 month ago.
How far apart are they able to implant?
Customer: replied 1 month ago.
My doctor doesn't think it can be more than a day apart!
Expert:  Dr Ted Manos replied 1 month ago.
We can't answer questions about implantation other than it happens in reproduction. Think in vitro fertilization and how they have fertilizations in the lab and then transfer the embryos into the uterus and they implant. Like I said patience is required and we'll soon know. Also, was the yolk sac for B normal size as that's helpful to know?
Customer: replied 1 month ago.
I am not sure. I know both have a yolk sac.
Customer: replied 1 month ago.
I have a repost from the scan in the ER. I think it measured Twin B yolk sac.
Expert:  Dr Ted Manos replied 1 month ago.
The yolk sac diameter should not be more than 5 mm.
Customer: replied 1 month ago.
This was taken last Saturday at the ER
Expert:  Dr Ted Manos replied 1 month ago.
No mention of yolk sac diameter which isn't usually measured unless it looks bigger than average.
Customer: replied 1 month ago.
I don't have a copy of the most recent one that was done Tuesday
Customer: replied 1 month ago.
since they didn't mention the yolk sac size that is a good thing?
Expert:  Dr Ted Manos replied 1 month ago.
I would think so. I've been doing obstetrics for more than 40 years and became excited when I saw realtime ultrasound for the first time. I purchased the original ultrasound machine as soon as possible. I performed my own ultrasounds and trusted what I learned to see and measure. I kept up with the technology but didn't justify upgrading my system as the basic stuff I needed worked well. Transvaginal ultrasound was a blessing seeing the fetus so early. Most importantly, I was able to keep my patients informed of the progress of their pregnancy. I found that patience by my patients helped but they trusted me which was at the heart of the matter. Don't worry about tomorrow as it's only an unknown. Be inspired by your pregnancy and what can be hoped for. Prepare for the possibility of the worst and hope for the best.
Customer: replied 1 month ago.
Thank you very much for the inspiring words and an inside look into it my little Baby B will make it. I have another scan next Thursday and I hope all goes well. That's all I can do is hope. One more question. I have some major constipation so is it okay to take Metamucil while pregnant since I take iron in my prenatal Vitamins and I. Think it's starting to bother my stomach at night as I wake up every night feeling like I have to go but can't!
Expert:  Dr Ted Manos replied 1 month ago.
Metamucil would be fine and the vitamins and iron are the culprits.
Customer: replied 1 month ago.
Well I'm telling ya they are killing me. I think it's even starting to give me hemroids!
Expert:  Dr Ted Manos replied 1 month ago.
It will start helping and you can take it in the morning and maybe late afternoon. Try not to force the issue as it can cause some hemorrhoid formation.
Customer: replied 1 month ago.
The feeling that I wake up with at night is like a burning feeling by my anus and a hurting type feeling in my lower abdomen by where my colon might be in the left lower side? Sound like a combo of constipation and hemorrhoid?
Expert:  Dr Ted Manos replied 1 month ago.
A good BM will make it better.
Customer: replied 1 month ago.
When I go it feels better. I don't go everyday and had issues before I got pregnant so being pregnant made it ten times worse!
Expert:  Dr Ted Manos replied 1 month ago.
Do the Metamucil twice daily and don't worry if you think you're needing to have better results