Bear with me as this story is a little long...
I discovered that I was pregnant over 5 months ago. I had my first ultrasound in early May. To me and my husband's surprise, we discovered that I was 11 weeks along with twins - we were overjoyed!
My first question to the OB who was doing the ultrasound was "identical or fraternal?" She quickly responded, "absolutely fraternal. I see two placentas and amniotic sacs". This was documented in my chart and my care continued under the belief that I was having fraternal twins. That week while I was examining my u/s pictures and comparing them to images online, I started to suspect she might have been wrong. My OBGYN's office has 5 Dr's on staff and I would continue to see most of them at different appointments throughout my pregnancy. At my second, third and fourth visits, I questioned the original diagnosis of fraternal twins and was quickly dismissed. They all said something along the lines of, "they do APPEAR to be in the same placenta, but the first doctor documented having seen two placentas, and the first u/s is the most accurate". I knew deep down that I was having identical twins and was beginning to get frustrated that nobody at my Dr's office seemed to be on the same page about ANYTHING (about several other issues as well). I even went to a 3D/4D studio around 18 weeks to do gender determination and was told by the sonographer that they were absolutely identical and she couldn't understand what the confusion was all about at my Dr's office.
At 24 weeks I began having back pains and some other strange symptoms. I rushed into the Doctor where they determined via ultrasound that I was showing signs of twin-twin transfusion syndrome (an extremely dangerous condition that can ONLY develop in identical twin pregnancies). I was sent to the hospital for an emergency u/s with the Perinatologist only to determine that the condition had developed to a state where it was too critical to treat. My baby girls were delivered that night via emergency c-section, weighing just over 1lb each.
Both babies survived delivery, but one died two days later. The other is now 5 weeks old, gaining weight and progressing well. She is predicted to survive, but due to a severe brain bleed that occurred early on, she is likely to have developmental delays. Best case scenario: she will be mildly learning disabled. Worst case scenario: she may never walk, talk or be able to feed herself.
My understanding now is that identical twins are known to be much higher risk than fraternal and are typically monitored more closely. For example, another OB that I have talked to has told me that he schedules routine ultrasounds every 4-5 weeks for healthy fraternal twin pregnancies and every 2-3 weeks for healthy identical pregnancies, specifically because the risk of twin-twin transfusion in identicals is about 15%.
I just cannot get over my anger that I trusted this group of healthcare providers, and I feel as though they put the pride of their colleague over the well-being of me and my daughters. There are ways to correct this syndrome when it is caught early on and, because of their mistake, I will never know if this is something that could have been corrected.
I am not out looking to make a quick dollar, and obviously our #1 concern is the well being of our surviving daughter, but the statute of limitations on medical malpractice claims is 2 years from diagnosis, and we may not know the extent of her brain damage or special needs until later than that. At the very least, I want to make sure that these doctors do better next time this situation presents itself, but I also feel that I am owed something. I lost the joy of my pregnancy and a daughter. My baby lost her sister and her health. Maybe everything would have turned out exactly the same if the original doctor had correctly determined what was going on, but because she didnt, I will never know...
Any thoughts/advice would be greatly appreciated!
Stephen: My understanding is that advancements in ultrasounds have made them incredibly reliable diagnostic tools. The only alternative would have been to have an amniocentisis performed on each fetus to compare DNA. Because they carry some risk for miscarriage, they would only do this if checking for chromosomal abnormalities. One OB that I have asked said that he has never mis-diagnosed identical vs. fraternal from an ultrasound and doesn't understand how one (much less four) supposed professionals all got it wrong.
Did they violate the standard of care? I guess I don't know. What I do know is that they told me that my pregnancy left no possibility for twin-twin transfusion and I ended up losing my daughter (and very nearly losing the other) to that very syndrome. I have to think that there is some negligence there...
STEPHEN
The primary legal question is, did the doctors violate the standard of care required to be followed by physicians in your jurisdiction? That question is most often answered by another physician who is familiar with that standard of care and who gives his opinion, at trial, in support of your case. The first person you should talk to now is a lawyer who handles medical malpractice cases for Plaintiffs.
Is there a more definitive test than ultrasound used to determine identical versus fraternal? In my opinion, basing such a conclusion on an ultrasound is like trying to draw a perfectly straight line without a ruler to guide the pencil. . . you're taking a guess based on merely eyeballing what you see.
Kathi S
The key question is what would have been done differently if they knew they were identical twins? The answer is nothing. It would not have changed the standard of care for an apparently normal pregnancy. Doing an ultrasound every 2 weeks that early in an uncomplicated pregnancy would not be part of the standard of care in most cases. It is very sad and unfortunate that you lost your child, but it is one of the things that just happens it's not anyone's fault.
Orignal From: Is this grounds for medical malpractice lawsuit?
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