The Importance of the Sonogram Tech in High Risk Pregnancy

I’m writing this post two weeks after my twins 1st birthday and I am truly blessed to be able to write this post.  My last post on the twins left off after I had received my diagnosis of monoamniotic twins, and I left the doctor’s office feeling like a science experiment (check out my earlier posts on the start of my twins journey).  Following the first doctor’s appointment, and like most twin or high risk pregnancies, I was told to start searching for a maternal fetal medicine (MFM) specialist for this pregnancy.  Since monoamniotic twins are so rare I knew I wanted to try to find someone who had at least seen this type of twin before.   We live in an area where I’m fortunate enough to shop around for doctors, but at the same time there were certainly enough opinions to go around.

Three of my not-so-favorite “opinions” were:

1) A doctor told me to terminate the pregnancy because they weren’t going to make it because the risk is just too high.  This was never an optiIMG_6678on for me or my family so we were able to quickly eliminate that doctor.

2) As I was shopping around for doctor’s one MFM doctor instead of directly stating she had never seen this type of pregnancy she tried to appear super knowledgeable about the subject because she “sat in” (operative word) on a delivery of momo twins.  This is even more hilarious after the fact because I had three medical students “sit in” on my delivery.  We could have had a party in the delivery room with the amount of people that were there.

3) I had a sonogram tech tell me that she thought maybe the twins were fraternal.  Now if you know anything about the differences between identical and fraternal twins you know it was about 100% impossible that our twins were fraternal.   The fact that there was one placenta on the screen should have been an indicator to the tech that fraternal twins was impossible,  I know that some fraternal twin pregnancies are misdiagnosed as identical twins due to the placement of the placenta but I was there to check for an amniotic membrane separating the twins so the thought that there could be two placentas was bizarre, and even I knew that with my limited medical knowledge.

I quickly learned not only is the maternal fetal medicine doctor important but so is the sonogram technician.  In my previous pregnancies I stayed with my regular OB and I saw a sonogram technician twice maybe three times, to check early on that it was a viable pregnancy, to check the gender, and finally the size of the baby towards the end of the pregnancy.  Seeing a maternal fetal medicine specialist was a different ball game.  I wish I had known exactly the importance and the type of control the sonogram technician would have through my pregnancy.  Please note every pregnancy is different and in no way am I saying to downplay the importance of the doctor.

sono 2In my pregnancy the sonogram technician spent more time with me than the doctor.  The imaging took 30 minutes at a minimum every sitting, and the MFM doctor comes in for five minutes to look at the sonogram tech’s pictures.  I saw the tech once a month, then twice a month, and eventually twice a week.  Again, the tech knows what dangers to look for and is in control of what is highlighted for the doctor.  My tech had been working as a MFM tech for over 15 years and had seen monoamniotic pregnancies twice.  Because of her experience she was well versed in the complications that could arise in a momo pregnancy.

Another interesting fact that I didn’t realize and I believe is pretty common is the MFM doctor doesn’t deliver the babies.  I ended up having to find another OBGYN that practiced at the hospital where I would be staying and they delivered the babies.

In most cases of monoamniotic twin pregnancies you enter the hospital around 24 weeks to be monitored.  In my case I was monitored twice a day, once in the morning and once at night, and if anything looked off or if I wasn’t feeling right they would monitor me again.  Since you’re in the hospital for weeks, in my case 6 weeks, my sonogram tech (and nurses) became like family.  I left my hospital room two times a week for a sonogram and seeing my tech turned into the highlight of my week.  It was fresh conversation and I was able to see the babies, it turned into a sense of security for me and I’m lucky to have had one tech for most of my pregnancy.

A couple of parting thoughts:

  • If you have the option to shop around for sonogram techs and doctor’s pick someone with experience in your condition and knowledge of the field.
  • Don’t hesitate to question them on their knowledge and even credentials.
  • If you have that gut feeling that something isn’t right with the doctor or the sonogram tech question it, or leave the practice.
  • Remember this is your pregnancy and you want the best for you and your baby(ies).

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