Surprised by a cleft lip and palate in one twin at birth

cleft lip twins

Author: Gillian Smith

 

We are a blended family. I have had three boys and my partner has had three girls from previous relationships, they range in age from 21 down to 6.

In February 2017 I went on a holiday to Queensland with my boys, I spent a lot of time feeling unwell, I felt as though I had pulled lower abdominal muscles and thought wow it’s been a long time since I went swimming, I felt nauseous because of the heat.

When we returned I still didn’t feel the best, I had at the end of 2016 had a mirena IUD removed and began taking the contraceptive pill, I was convinced it didn’t agree with me, after another month of feeling off I returned to the GP, I had what I thought was a mass in my stomach, fearing the worst I told my GP the pill doesn’t agree with me and I’m not sure that I don’t have something in my stomach.  She did a couple of investigations and instead of the news I expected (a return of cancer from years ago) she told me I was pregnant.  Not just with one but two babies and not just pregnant either, near on 14 weeks.

cleft palate and lip twins

Finding out I was pregnant with twins at 43 years of age

In shock we tried to work out how this was going to happen.  We didn’t live together we both had small houses, we had many children.  Either way the planning began (albeit a little late).  I did the Harmony test given my advanced age (43), it came back perfect, very low risk, it showed the presence of a Y chromosome so I had one maybe two boys in there, destined to never have a girl I was convinced it would be two boys.

Waiting patiently for the 20 week anatomy scan we still didn’t tell family and friends, hoping everyone thought I was eating too much. At 18 weeks I was diagnosed with Gestational Diabetes and after a week of diet change and blood sugars I was put on insulin before every meal, short acting before meals and long acting for overnight;  Just another element to add to the fun of an unexpected “Twin” pregnancy.  Each week I rang the clinic reported my blood sugars and increased my insulin.

20 weeks pregnant with twins

At 20 weeks the anatomy scan looked good, everything was as it should be Twin A was definitely a boy, no mistaking that!  He sat breech at that stage. Twin B, who was head down above was a girl! What a rush, can’t say I wasn’t a little excited. The only issue reported was the sonographer said I can’t find Twin B’s top lip to measure, you will need that checked in two weeks time, nothing to worry about she won’t sit still.  I wondered what that meant and decided to just put it out of my mind as an active baby.

Two weeks later at an obstetrics appointment the Dr reported the scan was great, they were a good size and everything was as it should be, except for Twin B’s top lip.  Let’s have a look, she said.  A minute later she confirmed Twin B did in fact have a beautiful top lip, I saw it and relieved the pregnancy was going well left for another two weeks.

32 weeks pregnant with twins

At 32 weeks I contracted Influenza A, it appears I had the flu shot too late.  I was so sick and all the coughing, I ended up in hospital on IV fluids and antivirals. I had steroid injections because the contractions were becoming real. If my white cell count raised any higher they were going in to get my babies.  Plus my temperature wouldn’t come down.  On day 5 the contractions stopped and my white cell count started dropping, I was allowed to go home and the babies were allowed to stay, a close call to say the least.

43 and pregnant with twins

36 weeks pregnant with twins

Time flew Twin A stayed breech and I was booked for a C Section at 38 weeks, why? Because the risk of chin lock is too great, okay, so this is how it’s going to be.  Then miraculously twin A turned at 36 weeks, I asked could I go for a VBAC. Surprised I wanted to the OB agreed. She said we had to induce at 37 weeks none the less.  I had to have an epidural in case of extraction and they would hook me up to Pitocin to ensure swift delivery of twin B.

A few days later I was starting to have hypos from the insulin and it was decreasing in dose every day, I knew this meant the placentas were becoming less useful and thought maybe I wouldn’t make it to 37 weeks, I was having what felt like constant contractions and had still not gotten over the flu, I was so tired and could barely move.

My sister wouldn’t take no for an answer and took me into PAC.

I was sorry as I felt I had been there so much, they knew me by sight.  After being checked over I was told that my cervix was 1 cm dilated. The dr was happy I was ok and was going to send me home until the midwife there said are you have another tightening now? I was, and they were becoming uncomfortable, she felt my stomach and said to the Dr this lady is in labour that’s a real contraction, nothing false here!   So I was taken off to a room to see what happened.

I so desperately wanted to make 37 weeks so I didn’t have premature babies, so they had the best chance, so we were all ok, but that was still three days away.  That night they gave me panadol and codeine to help with the pain and said sleep and we will reassess tomorrow if nothing happens overnight.  By this stage the endocrinologist had said no more insulin for me and was going to speak to the Obstetrician.

Next morning came and the contractions were gone, I didn’t know whether to be happy or sad, the Ob said I think we’ll let you go home and see you on Monday as planned. I asked what should I do about the diabetes, she hadn’t heard I was no longer on insulin. When she heard this she said change of plans, you are having these babies today.

 

VBAC with twins at 36+2 weeks

I was taken to a delivery suite, epidural in (only working on one side hmmm), and the drip set up, they broke Twin As water and we were off, three and a half hours later he was out (surreal having pain on one side for a birth, I hated it, I felt I had no control), they popped him straight on to my chest I could see the top of his little head and he felt so warm and beautiful, the contractions weren’t letting up though and I soon had to ask my partner to take him so I could get this other baby out.

Twenty minutes later she was delivered footling breech extraction. I opened my eyes at one point and saw a room with about 12 people watching, two doctors had their hands inside me and a set of forceps. She was a bits stuck as my cervix had closed up too much.  She was floppy and a funny cream colour, they took her straight to a resus cot and started working on her. I don’t know how long it was before she started breathing and crying but I was so relieved when she did, they then went about checking she was ok.

A surprise cleft lip and palate in one twin

I asked my partner can I have our baby boy back I haven’t even seen his face.  My partner looked shocked and very hesitantly turned him around to me.  There it was, we had a cleft lip and palate in one twin.  I hadn’t seen it, I said ‘oh no he has a hare lip, doesn’t he? (they don’t call it that now I know but I didn’t then), doesn’t he’? I nearly shouted, My partner said ‘yes I think so’, I took him back and marvelled at how beautiful he was despite this major shock.cleft lip and palate in one twin

The midwives and doctors all assumed we knew and were surprised we were so shocked by his little face.  I got to hold my baby girl for a moment before they took her around to NICU to make sure she was ok, soon after they took my baby boy as he needed a nasogastric tube for feeding and his blood sugars were a little low.

twins born at 36 weeks

Our journey with a cleft lip and palate in one twin

We spent 11 days in Special care to establish feeding and ensure there were no other issues, Eli had a cleft palate as well so feeding was difficult at first.  When I saw my obstetrician later she said I double checked the scan and they definitely said Twin B didn’t have the lip, I’m so sorry we didn’t know, I said it’s actually ok, I am pleased I didn’t know as I would have stressed too much, read too much and known too much before he was here.  This was I still have euphoria to go along with it.cleft palate twins

Twelve months and two operations later his lip and palate are both fixed and he is even more handsome than the day he was born.VBAC with twins

 

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