Mono-mono: a rare pregnancy of a DF resident

2023-04-25 05:00:30

A resident of Ceilândia, administrative assistant Meiry Rodrigues, 33, is in the final stretch of an extremely rare pregnancy. With delivery scheduled for this Tuesday (25/4), in Brasilia, she has a mono-mono gestation, when two babies share the same placenta and amniotic sac. The condition occurs in less than 0.02% of pregnancies worldwide.

The possibility is so small that Meiry considers herself a lottery winner, despite the fact that the situation poses a danger to both her health and that of babies Laura and Laís. The administrative assistant runs a high risk of pre-eclampsia and even fetal death, but says she managed to carry her pregnancy with ease. “I’m lucky,” she says.

Since discovering the condition, Meiry has had a new surprise at every medical appointment. She learned that she was pregnant for the first time in her life in the sixth week of pregnancy and, initially, the tests indicated that she would be just a baby. At the 12th week, happiness doubled: she found out that she was expecting twins.

Fear, however, would become part of the follow-up routine from the following month onwards. At the 16th week, Meiry discovered that the pregnancy was mono-mono.

What is mono-mono?

Monochorionic gestation, that is, with two babies sharing the same placenta, occurs in only 25% of cases of twins: in these situations, the babies are identical. In the case of Laura and Laís, however, the two also share the amniotic sac and there is a risk of blood transfer between the sisters.

“The amniotic sac is like a bag, a thin film that contains the babies. In general, each one has their own space delimited by this bag, but in the case of Meiry’s daughters, what we have is a complete sharing”, explains obstetrician Juliana Rezende, who has accompanied Meiry’s pregnancy alongside obstetrician Emilie Zingler. Both are from Brasilia.

Mono-mono pregnancy occurs when the embryo divides from the ninth day of pregnancy. If the division had occurred following the 10th day, there was a very high chance that the babies were conjoined. The two will likely separate on the eighth or ninth day, and will be identical twins.

Meiry Rodrigues, 33, resident of the DF, has a very rare mono-mono pregnancy – Metrópoles

Meiry Rodrigues, 33, has her delivery scheduled for this Tuesday (4/25)Matheus Veloso/Metropolis

Meiry Rodrigues, 33, resident of the DF, has a very rare mono-mono pregnancy – Metrópoles

Meiry’s pregnancy is of the mono-mono type, which occurs in only 0.02% of cases, and which has its own risksMatheus Veloso/Metropolis

archyde news by Metrópoles 1 partner

Meiry Rodrigues, 33, resident of the DF, has a very rare mono-mono pregnancy – Metrópoles

Babies Laura and Laís share exactly the same space. Doctors warn that it is a case of luck: in 70% of these conditions, there is a risk of death for the babiesMatheus Veloso/Metropolis

Meiry Rodrigues, 33, resident of the DF, has a very rare mono-mono pregnancy – Metrópoles

Laura has a heart malformation and will have to undergo surgery at birthMatheus Veloso/Metropolis

archyde news by Metrópoles 2 partner

Doctors accompanying Meiry’s case, Juliana Rezende and Emilie Zingler – Metrópoles

Doctors Emilie Zingler (left) and Juliana Rezende were responsible for monitoring the caseMatheus Veloso/Metropolis

Meiry Rodrigues, 33, resident of the DF, has a very rare mono-mono pregnancy – Metrópoles

Meiry and her husband, Paulo Marques, 33, had surprises every week of pregnancy, but claim to have gone through everything with faithMatheus Veloso/Metropolis

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The doctors, who research risk conditions in pregnant women, began to observe Meiry’s case when they learned regarding her rare condition. Mono-mono pregnancy needs to be evaluated weekly for the risks it poses.

“As babies share the same space and have their umbilical cords very close, there is a great risk of the cords tying a knot, which can be fatal”, explains Juliana. Emilie adds: “Therefore, the risk of death of babies in mono-mono pregnancies is high, it happens in more than 70% of cases”.

The discovery of these risks kept Meiry awake at the beginning of her pregnancy. “I was very scared. I researched the mono-mono pregnancy and everything I read was very negative. It was only with the support of the doctors and my husband that I was able to calm down”, says the administrative assistant.

Heart problems

Even with the diagnosis, the surprises weren’t over yet. In the 24th week, the tests showed a heart malformation in one of the babies. “Laura has a condition that will require surgery right following birth, so we had to organize ourselves to receive her”, says Meiry.

The organization even had to involve Justice. The administrative assistant’s health plan does not provide for the possibility of giving birth in any hospital in the DF that has a neonatal ICU. To ensure coverage, the plan had to be brought in court.

Laura’s heart condition also forced the doctors to make a risky calculation. In cases of mono-mono pregnancy, the orientation is to opt for cesarean delivery from 32 weeks of gestation. However, in order for the girl to be stronger to undergo the surgery, the specialists decided to keep the pregnancy longer. Meiry is already in her 34th week.

“We were pushing with our belly — in this case, Meiry’s belly”, jokes Juliana. “It’s such a case of luck that we can’t take chances,” she says.

“I feel lucky. I know regarding her condition, but Laura means victorious, and that’s how I feel. With everything that might have happened, feeling my daughters with me is like having won the lottery several times in a row”, guarantees Meiry.

Expectations for childbirth

Laura and Laís are fine, they are between 44 and 45 centimeters and weigh 2.5 kg and 2.3 kg, respectively. The doctors point out that the healthy situation of the babies might only be guaranteed by a close obstetric follow-up.

“It is important that pregnant women, in case of any suspicion, seek the emergency as soon as possible. In Brasilia, we have the HUB, which offers free and specialized assistance for these cases, like what happened to Meiry”, recalls Juliana.

When Laura and Laís get home, they will find the room ready, all prepared by Paulo Marques, 33, the girls’ father. “I always tried to convey tranquility to Meiry. Of course, we went through many surprises, but we always supported each other a lot”, says the husband of the administrative assistant.

The vigilante already has a daughter from a previous relationship. Alice, 8, is most excited to see the babies soon. “She is in an anxiety that cannot fit”, says Paulo. Meiry, however, shows trembling hands when she talks regarding the expectation for childbirth. “I know everything is going to be okay. I have a lot of faith. I think the nervousness is the desire to meet them as soon as possible”, concludes the mother.

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