I did it!

I made it to 34 weeks! Which also means I've reached the end of my complications chart. I guess after 34 weeks the rates of pre-term complications are all nearly zero. SWEEEEET!

Survival: 97%
Respiratory Distress Syndrome: 14%
Intraventricular Hemorrhage: 0%
Sepsis: 4%
Necrotizing Enterocolitis: 3%
Intact, long-term survival: 97%

There you have it folks. And on top of it all, they should weigh nearly 5 lbs now. That means we'll be able to use the carseats we bought when we bring them home from the hospital! WOOOO! Now babies, I'm large and viciously uncomfortable. You can come out now so I can get 2 hours of pleasant, deep sleep instead of 2 hours of uncomfortable, non-deep sleep each night. :-) As much as I'd love to cook you both another two weeks, I think I might have a nervous breakdown from lack of quality sleep. Now I don't expect to have amazing sleep once you arrive...I just want the little sleep I do get to be comfortable. I also want to be able to sit and lie down comfortably instead of having a painful back 24/7. I promise to make really delicious breastmilk for you and cuddle you the way only a mommy can. And I might let your daddy hold you if he sits down first. ;-) We have really comfy cribs all ready for you and I promise not to make either of you sing the 4 questions at the Pesach seders this year. Now, isn't Purim a nice time to have a birthday? It also happens to be the full moon...

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33 Weeks!

Wow. I still can't believe that I made it to March. I'm really psyched for my ultrasound tomorrow, because they'll do measurements and I'll find out the twins' estimated weights. I also wonder what my cervix looks like, but I don't think they're going to check it. My contractions have definitely calmed down since I started on antibiotics for my UTI, but I still get a few every day. (Much better than a few every hour!)

I also thought you all might want to see how awesome the complication rates are at 33 weeks (yeah that sounds weird, but I couldn't figure out a better way to put it):

Survival: 96%
Respiratory Distress Syndrome: 34%
Intraventricular Hemorrhage: 0% (yay!)
Sepsis: 5%
Necrotizing Enterocolitis: 2%
Intact, long-term survival: 96%

Not bad, eh? And I'm not really worried about respiratory distress because I had the steroid shots last week. Woooo!

Getting Bigger

I posted my 30 week belly pic! At my sister's request, I'll start posting new pics every week. :-)

Speaking of 30 weeks, here are the updated survival rates & complications statistics:

Survival: 93%
Respiratory Distress Syndrome: 55%
Intraventricular Hemorrhage: 2%
Sepsis: 11%
Necrotizing Enterocolitis: 15%
Intact, long-term survival: 90%

This was my OB's short term goal, so I'm pretty ecstatic to have made it this far. Now if we can just get to 37 weeks!

28 WEEKS!!

My babies now have a greater than 90% chance of survival if they're born this week (and it only goes up from here)! Not only that, but I found a really cool chart that shows other preemie problems that can occur and their rates of occurrence depending on which week a baby is born. Yes, these values are for singletons, but twins generally have better chances of survival and less chance of complications than a singleton born at the same number of weeks.

At 28 weeks...

Survival: 90%
Respiratory Distress Syndrome: 65%
Intraventricular Hemorrhage: 4% (woooo!)
Sepsis: 25%
Necrotizing Enterocolitis: 25%
Intact, long-term survival: 80%

And it only gets better from here!

Big Day

Well, we made it! 24 weeks! For those who don't know, this is when doctors have determined "official" viability--and babies born now have more than a 50% chance of survival (although I read somewhere that with intervention it's closer to 90%, but I think that's being a bit optimistic...)

My memory is starting to slip, though. Yesterday I put eggs on the stove to boil and forgot about them for over a 1/2 hour. Luckily, eggs don't overcook so easily and they turned out fine. Today, though, I left a bag of popcorn in the microwave for a full 5 minutes. It's kinda burnt, but not inedible. :-) Just so you know, my microwave is not that powerful and it generally takes about 3.5 to 4 mins to cook a bag, not the 2.5 it tells you to leave it in for. There were also still some unpopped kernels at the bottom of the bag, so you'll never get them all to pop no matter what. lol

Will update tomorrow with the report from the OB, although there probably won't be much to report. I think I may have a yeast infection from the antibiotics I took earlier in the month for my UTI, so we'll see if I'm right (or if I have another UTI ick).

Cervix Update

I had another cervix check ultrasound today. It's still closed! :-) It also looked like it was lengthening a bit past the cerclage stitch and was measuring 1.8cm or so, which is excellent. The twinners look good too, but no measurements or good pictures today. Sorry!

In other news, I'm 23 weeks today!! So our viability survival rate has now increased to 13%-42% (mind you that's survival rate and has nothing to do with quality of life, so either way we want the twins to stay put for awhile longer).

22 Weeks

Yay! I made it to 22 weeks! For most this isn't a milestone, but for me it means my babies start having *some* viability. Of course, being born at 22 weeks is a very bad idea and the babies would have less than a 10% chance of survival, but less than 10% is better than 0%. And they each weigh about a pound (maybe a teensy bit more), which is excellent.

Speaking of weight, I think I gain all my weight in one day a week. I'll be going steady at 157 for a good solid 5 days and then BAM 159. It's rediculous! After watching the Biggest Loser finale last night, I was having visions of me at 200lbs and it ain't a pretty sight. But if I go on gaining 2lbs a week (or 3), by 32 weeks I'll be at 180+. And that's with the babies each gaining about 3oz a week till 28 weeks. After that, they start gaining more than 5oz a week until about 32 weeks. Then, it's about a half a pound a week until the end. So if the babies are gaining more weight, mommy's going to gain more weight. Ewww. As much as I want them to be born at 37 weeks, the fat girl part of my brain is going "dude, I want 'em out before I blow up like a blimp." :-) I seriously wish I could do something about my appetite. If I could be satisfied with three meals a day, I'd be fine. But right now I get hungry so often it turns out to be more like five meals--plus snacks. Oatmeal w/ banana & raisins for breakfast, a yogurt for lunch, maybe a bag of microwave popcorn for a snack, maybe some celery w/ peanut butter for another snack, maybe some tomatoes or an apple, a "Tasty Bite" Indian meal for supper, some chicken w/ kugel for dinner... It doesn't sound too bad on paper, but when you're getting no exercise and enjoy having a cookie or two for dessert, it's too much.

Anyways, enough of the weight complaints. I had a dr's appt today and so far so good. My fundal height is 28cm and growing (as you can see by the new belly pic I posted yesterday). I have an ultrasound scheduled for next week, so we'll get to see how my cervix is holding up. I'll be having my gestational diabetes test in a few weeks and possibly a fetal fibronectin test as well to see if I'm at risk for actually going into labor.

Speaking of going into labor, one of my IRL friends is! :-) She's been in the hospital for a few months (not pregnancy related), so we hope that giving birth will help her and maybe she'll get to go home soon! I can't wait to find out if the baby is a boy or a girl and how her labor went. I'll let you know when I know.

Found It!

Thanks to some l33t google searching, I found a mathematical equation that gives twin premature survival rates. P(m) = (375 x P(s)) / (275 + P(s)) with P(m) being the survival rate for multiples and P(s) being the survival rate for a singleton pregnancy. As you will see, the rate of survival for multiples is very slightly higher than for singletons even though they may have a smaller birth weight. I will do the math for you and make a chart!

21 weeks or less: 0% single & multiple
22 weeks: 0-10% single / 0-13% multiple
23 weeks: 10-35% single / 13%-42% multiple
24 weeks: 40-70% single / 47%-76% multiple
25 weeks: 50-80% single / 57%-84% multiple
26 weeks: 80-90% single / 84%-92% multiple
27 weeks: > 90% single / > 92% multiple

These are all rounded down to the nearest percent. It is true that there have been babies born at 21 weeks and earlier that have survived, but the rate is so very low that it's not really measurable. This is why I have kept it at 0%. These rates also depend a lot on weight of the baby/babies at birth. A lower weight baby is going to have a far smaller chance of survival than a higher weight baby born at the same gestational age. They've also shown that female babies have a higher rate of survival than male babies born at the same gestational age. How far has science come!

Chart

As Nancy so aptly pointed out, the previous post is a chart for singleton births. I'm still searching for a twin chart and will post it when I find it. Btw, Nancy, did you know that if you google search "gestational age survival rate", your blog post is on the first page? :-)

Survival Rate by Gestational Age

My blogger friend Nancy posted this chart a while back, and I want to have it for my own records. It's a great chart and I encourage everyone to make a copy for themselves.

There are more detailed charts out there, but this one is nice and basic.

Advances in medical care have made it possible for many premature infants to survive and develop normally. However, whether or not a premature infant will survive is still intimately tied to his or her gestational age:

21 weeks or less: 0% survival rate
22 weeks: 0-10% survival rate
23 weeks: 10-35% survival rate
24 weeks: 40-70% survival rate
25 weeks: 50-80% survival rate
26 weeks: 80-90% survival rate
27 weeks: greater than 90% survival rate

(note: many charts simply list the first number. This one gives a better range.)