Friday, November 18, 2011

When I was almost 11 weeks pregnant we found out we were expecting not only twins, but identical twins. I won't lie, it was a shock that came with a huge mix of emotions from absolute joy and excitement to worry and fear. I then did a good share research about twins and twin pregnancies. Since we were having monochorionic/diamniotic (one placenta/two amniotic sacs) twins, I found out the risks were even higher. Even though my husband thought I was over reacting, I requested an early referral to high risk specialist (MFM). The closest MFM was in Dallas 100 miles away. We had a perfect u/s with the MFM at 18 weeks and found out we were having two boys.

My nerves were calmed for a short time, but I kept getting a nagging feeling like something was going to happen. One of my worst fears was confirmed when we came back 4 weeks later for a routine u/s at 22 weeks. Baby A had very little amniotic fluid surrounding him and Baby B had more than normal. Baby A was also measuring behind. The MFM diagnosed stage I TTTS - a fairly rare condition affecting the shared placenta of identical twins causing abnormal blood vessels which transfuse blood between the twins. He contacted the Dr's in Houston who perform intrauterine laser ablation surgery for this condition. They felt we were not candidates for surgery so we continued with weekly u/s, modified bed rest and high protein diet for me.

By the time I came back for my 24 week u/s, the MFM thought he saw reverse end diastolic blood flow in Baby A's umbilical cord and believed they were both only measuring 22 weeks. The Dr. was very grim with the prognosis of the pregnancy safely continuing much longer and did not give us much hope that our babies would survive if they had to be delivered now. Since our babies shared a placenta and blood flow, if one baby died in utero, the other would have to be delivered immediately and could suffer serious problems. The Dr. then suggested we might need to consider doing a procedure to clamp off the umbilical cord of Baby A to give Baby B a better chance. There were so many unknowns. After the appointment I was directly admitted to the high risk OB unit for steroid shots and close monitoring. The next few days were by far some the worst of my entire life.

We spent the weekend digesting the basically hopeless information we had received and prayed for a miracle. The next week we saw the other Dr. in the MFM practice who shed new light on the situation and gave us hope that our babies could survive. I give Dr. P much credit for keeping me pregnant to the point where delivery was safer. I stayed on hospital bed rest and Baby A continued with intermittent absent end diastolic flow for 4.5 weeks. They both continued to grow and pass the NSTs and BPPs. The Doctors were amazed at how far we had gone and how well my two little fighters kept doing despite the problems they were having. On the morning of 7/11/11 my husband I prepared for the morning u/s and I told him jokingly that it would be a neat birthday if they were born today. The u/s showed Baby A in reverse flow and his growth had dropped to 7th percentile. The Dr. made the call that it was too risky to continue the pregnancy and we would meet our babies today!

I had to wait 6 hours for my c-section because I had already ate breakfast. I had literally just received my 2nd round of steroid shots before the c-section. Things went crazy fast when I got down to L&D. The spinal went in easy, but I had the fear that I may still be able to feel the pain - but it worked! It's kind of a blur but I remember there must have been at least 10 people in that room. Before I knew it they were pulling out Baby A who we named Owen James. They told me he tried to cry but I wasn't able to hear it. He weighed 2lbs even and was 13" long. Baby B was well wedged up in my uterus and didn't want to come out! Miles Reed was born crying two minutes later. He sounded like a little kitten! He weighed 2lbs 7oz and was 14.25" long. Both had apgars of 5 and 7. They were stabilized and the NICU team stopped by my head on the way out of the OR so I could see my babies for the first time. My husband went with them to the NICU.
About 2 hours after my initial recovery on the way to my postpartum room, the nurse took me to meet them in the NICU. The Neos told us they were happy with how well they were doing, but they were still very critically ill babies.

Owen James
Miles Reed

It felt like a dream. I could hardly believe that these two teeny babies were actually mine. As soon as my anesthesia wore off I was upstairs again with them again. Even though I was exhausted, I couldn't stay asleep for more than couple minutes. I was so happy, excited, but scared. I questioned if I had the strength to handle these next few weeks and months. I wasn't quite convinced yet that I would be taking babies home. Most of all I just tried to have faith that they would be okay.

We were very fortunate for them not to have any major complications in the NICU. Due to their immature lungs, it took them a while to get the breathing part down. Owen was on the vent for about 3 weeks, CPAP for a little over a week, and then O2 nasal cannula on and off for about 4 weeks. Miles progressed a little faster and was on the vent for a little over 2 weeks, CPAP for almost 2 weeks, and about 2 weeks on the cannula. Miles did however have a moderate PDA and was given Indomethecin which closed it to small. When they were 33 weeks GA they were transferred to the NICU close to our home. Then they spend 5 more weeks there weaning off O2, maintaining their temps, and learning to nipple feed. Miles was a great breast and bottle feeder almost right away while it took Owen a little longer to catch on. After 70 days they came home together and have been doing wonderful ever since. We are so doubly blessed with our little miracles!


Precious and priceless so lovable too, the world’s sweetest littlest miracle is, a baby like you.

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