The Proof is in the Pathology Report

I finally got my hands on the pathology report from the girls' placenta. The report states that the kiddos are monochorionic diamniotic. Monochorionic means that there is one placenta. Diamniotic means there were two gestational sacs. Usually this is abbreviated as mono/di. Almost all mono/di twins are identical. There are times when two placentas can be close enough to fuse. If two placentas had fused, this would not tell us if the kiddos were identical as both identical and fraternal twins can have fused placentas. The report would say the placenta was actually di/di if it was obvious two placentas had fused.

The girls appeared to be in one large gestational sac with a very thin divider. This alone made us pretty sure that they were identical as fraternal twins are more likely to have two distinct sacs. One doctor put doubt in our minds during an ultrasound because he was not convinced they were identical. I should not have let him influence me as neither Cork nor I were happy with the care he provided. After our one and only appointment with him, I called the hospital to ensure that I would never have another appointment with him. Even so, it was hard to ignore some of the things he said during the ultrasound. This pathology report proves him wrong, especially because it also states that the "specimen" may actually be monochorionic, monoamniotic. Mono/mono twins are always identical. Mono/mono twins share both a placenta and an amniotic sac.

We had so many ultrasounds during the pregnancy. By the end we were having an ultrasound once per week. We were traveling all over the city going to different locations since the ultrasounds had to be on a certain day and we didn't have much of a choice in availability. More than one ultrasound tech told us the girls were probably identical. When one of them was looking at where the umbilical cords inserted into the placenta, she stated that if they'd separated a day later they probably would be mono/mono. Identical twins can separate at three different stages of early development. If they separate from day one to three, they will have two sacs and two placentas. Days four through eight they will share a placenta, but have separate sacs. Days eight through twelve they will share a placenta and a sac (mono/mono). I'm so glad the girls were not mono/mono as they brings a whole other set of hazards, including cord accidents. The rate of complications with mono/mono twins is much higher than mono/di or di/di. Hospitalization prior to delivery of mono/mono twins is almost mandatory.