By: Jennifer Murray

Operation: Hospitalization (28 weeks) and An Explanation of Mono-Amniotic Twins

Friends and family,

Please read this very long post to fully understand what our babies are up against in the coming weeks. It is long, but it is just a complicated situation and difficult to explain.

We have made the decision, in conjunction with our doctors, to have Jen admitted to the hospital one week from today. While this is difficult news to deal with, we believe it is the best thing for our baby boys. And, we never thought we would have to make this decision because our doctors thought that preterm labor or some other complication would have forced Jen into the hospital by now anyway.

Why get admitted?
Sorry, but this is kind of a difficult situation to explain, but I will try:

Quad pregnancies are high risk pregnancies for many obvious reasons. But, we are not dealing with just a “normal” quad pregnancy. As many of you know, at least two of our boys are identical twins. We know this because they share the same outer (chorionic) sac. This is not uncommon for identical twins.

Most identical twins who share an outer sac, however, have their own inner (amniotic) sac which keeps them separate from each other. Our identical twin boys do not have two inner sacs, they share just one sac. This situation is a very rare condition known as monoamniotic (mono-mono) twinning. Identical twins are somewhat rare to start with, but only 1 in 100 sets of identical twins are mono-mono.

The problem with mono-mono twins is that because there is nothing in there separating the two of them. They almost always get their cords all twisted and tangled up. And, unfortunately, about 25-30% of monoamniotic twins do not survive until birth because of this cord entanglement. This is why this pregnancy has been so difficult on Jen and I emotionally. We have been told since the very beginning that there is a chance, at any time during this pregnancy, that one of those cords will get pulled tight and either cut off blood supply to the babies, or even get a cord wrapped around one of the babies’ necks causing their death. And, in most cases, if one of these mono boys dies, the other will most likely die shortly after that.

The silver lining in all of this is that although the mono-mono twins are in grave danger with everyday that passes, the other two “innocent bystanders” that are in their own sacs are probably going to be okay if the mono-mono boys die. As difficult as it is to think about, if one or both of our mono boys die before 28 weeks, we would have to simply give them to the Lord and let them go. It would not be right to deliver all four babies at less than 27 weeks gestation in order to try to save the two mono-mono boys. The risk of birth at this extreme prematurity would put all four of them in mortal danger that we are simply not willing to take.

The good news:
The good news is that we have nearly made it past that early stage of extreme prematurity with all four boys surviving. At 28 weeks, Jen and I have made the very difficult decision that we would be willing to deliver all four babies in an attempt to save the mono-mono boys. So, if the mono-mono boys are still alive one week from today, Jen will be admitted to St. Vincent Women’s hospital for the remainder of the pregnancy. During this time, our babies will be monitored for approximately one hour, three times per day.

The hope is that our doctors will be able to detect a problem with cord entanglement before it becomes a fatal problem. They have made it very clear to us that although they will do everything they can, these cord accidents can be sudden, so there are no guarantees. We may do all of this only to loose them anyway. But, even if there is only a slight chance that we could save them by voluntarily being admitted to the hospital, we are willing to do so.

The prospect of going to the hospital for up to one month is not one that either one of us is looking forward to. If our boys are still doing well at 32 weeks, (Feb. 2nd) our doctor will probably schedule a c-section near this time. By then, the boys should be developed enough that they would be nearly out grave danger. This would be considered the best-case-scenario. There would be no longer be a good reason to leave these mono-mono twins in there at the risk of a cord accident.

Jen has a lot of discomfort ahead of her; this much we are sure of. I understand that we are young and have not experienced much adversity in our lives, but I can tell you that this is the most difficult thing either one of us has ever had to experience. God has given grace in abundance and has spared us from the 24/7 agony of waiting to see if our children survive, but it has been, and continues to be a daily struggle.

Would you please pray with us that God would fill Jen and I with the Holy Spirit and comfort as we await God’s timing for the birth of our children? It is so difficult to avoid worrying constantly about our boys. God will decide if He chooses for them to survive. We know that He is in ultimate control of every detail of this situation.

May God be glorified as we pass through this trial that He sovereignly placed in our path! He is sufficient for our every need!

Thank you for caring for us friends,

Brad and Jen Murray

Two outer sacs, two inner sacs
(Typical Fraternal Twins)

One outer sac, two inner sacs
(Typical Identical twins)

One outer sac, One inner sac
(Our rare mono-mono twins)

(Post copied from www.triplet-update.blogspot.com)

3 Responses to “Operation: Hospitalization (28 weeks) and An Explanation of Mono-Amniotic Twins”

  1. Shanese Parker
    September 18, 2008 at 9:35 pm #

    Hi. This is Shanese i was very interested in your story i just recently found out that i was expected mono-mono twins also and you can’t help but to think and worry about your kids. it’s very hard on me because i am only and raising two kids on my own. I dreed going to the doctor not knowing what the doctor is going to say i have heard of all kinds of stories about twins especially the kind that we are caring. But reading yuor article just reasures me that all i need to do is put it in God’s hand and he will take cae of the rest. Thanks for sharing your story. I will keep you in my prays.

  2. Jessica
    October 17, 2008 at 11:35 am #

    Hi, I enjoyed your post on Shannon’s blog, and came back to read your quad story. I’m still in the middle of it, but I had to comment when I saw that you had a set of momo twins too. My two youngest are momo twins, and I’d wondered in your early part of the story if yours were, when I read the comment about “they can switch places” and when I looked at the ultrasound.

    I know the stress and pain of that pregnancy, and you had two other little lives to put in the picture too . . . wow. All I can say is your evident faith through your journey is a testament to God’s grace to us.

    And your boys are beautiful!

  3. Anonymous
    November 24, 2009 at 7:18 pm #

    MoMo twins aren't 1 in 100, they are very rare. Only one in 35-65,000 twins share the same sac and placenta. I have the same situation with my twins, and I'm only 11 weeks on, but I've done lots of research and every site I've found says the higher number, not 1 in 100. I have found a few uplifting posts on couples in the same situation, and just know that they have learned a lot in the past 10-15 years that can save the babies lives, and my perinatologist is going to admit me to the hospital at 24-26 weeks on 24/7 monitoring of the babies. I hope you have the same options, as that seems to help their survival rates go up to 100%. Hope all is great with your quads, what a blessing God has given you! It's truely a miracle in progress!

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