I had four early twin ultrasounds due to my history of losses – all within a space of one and a half weeks which is a bit full on now that I look back on it, but it gave me so much peace of mind at the time. The TTC journey is a rollercoaster for sure. I also had an extra ultrasound at almost 8 weeks (7+6 technically) as part of the hospital’s requirements to be referred for obstetric care with them as they needed to confirm viability themselves (or something).
Note: if you want to see all my beta results including other ones in addition to the below on days that I didn’t have ultrasounds, here is my full list of early HCG results for the twins (and also how they compared to my singleton).
Back to ultrasounds. My first ultrasound was at five weeks exactly, and the goal of having it done so early was to rule out an ectopic pregnancy as instructed by my doctor. Going into it, honestly, all I was hoping for was to see a baby in the uterus, and for it to not be another ectopic. This is the first inkling that it could be twins. That there was a chance.
The second ultrasound a few days later at 5+3 made it feel like it could be starting to be real. Seeing that the second sac was still there filled my heart with hope. And the third ultrasound, where we were able to see both twin heartbeats, is what sealed the deal for me. From that moment on, I knew in my heart of hearts, that I’d really be a twin mom! Although I had a few signs earlier, given that the start of this twin pregnancy was so different from my first singleton pregnancy.
Here are the transcripts from my early twin ultrasounds, as well as some images of what could be seen at each ultrasound. I’d say it wasn’t until the seven-week ultrasound (almost eight weeks pregnant) that I saw a jellybean-like blob that could look like a baby – well two babies! Before that, they just looked like dots or circles, which I understand are the fetal poles.
Five Week Twin Ultrasound
- 5 weeks 0 days pregnant
- 21 DPO
- 2800 HCG
FINDINGS: Transabdominal and transvaginal scans were performed. Two cystic structures are evident within the fundus of the uterus. These have the appearance of early gestational sacs. These are too small to see fetal pole, yolk sacs or heart beats – consistent with known dates.
Two corpus luteal cysts are evident on the right. No adnexal pathology or free fluid seen.
COMMENT: Appearances suggestive of an early dichorionic, diamniotic twin gestation however this is too early to assess viability.
Five And A Half Weeks Pregnant
- 5+3 weeks pregnant
- 24 DPO
- 8650 HCG
Thank you for referring your patient for assessment of early pregnancy.
CLINICAL INFORMATION AND HISTORY: previous ectopic on the left side. Fallopian tube removed. 1 previous live birth (now 2 years old). Confirm dates and viability. Expected gestational age by LMP is: 5 weeks 3 days. Transabdominal (TA) and Transvaginal (TV) scans performed. Chaperone: friend present. Declined nurse.
FINDINGS: This is a TWIN intrauterine pregnancy. Two separate gestation sacs with a thick dividing membrane. 2 yolk sacs are evident in both sacs. This is a diamniotic, dichorionic pregnancy.
Gest Sac (1): 8mm. Gest Sac (2): 9mm. The cervix appears closed and long. No adnexal mass and no significant free pelvic fluid is detected
COMMENT: Diamniotic, dichorionic twin pregnancy. Viability has not been confirmed.
(* A yolk sac is almost always visible when the MSD is greater than 8mm on a transvaginal scan and 16mm on a transabdominal scan. A fetal pole may not be seen until the MSD is greater than 20mm on a transvaginal scan, and 25mm on a transabdominal scan. )
Six Week Twin Ultrasound
- 6+3 weeks pregnant
- 31 DPO
- 70,700 hcg
ULTRASOUND OBSTETRIC – DATING
Thank you for referring your patient.
INDICATION and HISTORY
Early pregnancy ultrasound. Scan 1 week ago noted DCDA gestational sacs but no fetal pole. Additional history given by patient: Previous Caesarean: No. Gestational age is 6 weeks 3 days. Transabdominal and transvaginal scans performed with verbal consent.
FINDINGS: This is a live TWIN intrauterine pregnancy with 2 sacs and 2 fetal poles. I.E. dichorionic, diamniotic twin pregnancy. CRL (1) = 5 mm. CRL (2) = 6 mm. The uterus is retroverted and the positions of the gestational sacs are normal. No pelvic abnormality found. There are two right side corpus luteum measuring 18 mm and 22 mm.
COMMENT: Live embryos, twin pregnancy, chorionicity as above. Gestational age and EDD above are confirmed.
Practice point: Dichorionic twins have a 1 in 7 chance of being monozygotic – i.e. identical.
Seven Week Twin Ultrasound
As I mentioned, this was an unplanned ultrasound that the hospital needed on the day to confirm viability on their end, so I could be assigned to their obstetric care team. It was done at 7+6 weeks pregnant.
My records for this in my patient portal have a link that is restricted to only hospital staff (and presumably my doctor), so I can’t tell you what the report says. They also didn’t give me any printed ultrasound photos (neither did they email me any) but they did let me take one photo of the screen. This was the first time the babies had a baby-like jellybean shape.
