Multidisciplinary Fetal Care Helps Twin Boys Thrive

Meghan and Nathan were ecstatic to learn they were pregnant with twins. This was their first pregnancy, and everything had been going smoothly until a routine ultrasound at 24-weeks showed that one of their babies was not growing as quickly as the other. The couple became worried when their doctor diagnosed twin-to-twin-transfusion syndrome (TTTS), a prenatal condition in which twins share unequal amounts of the placenta's blood supply and can result in different growth rates. If left untreated, TTTS can cause extreme prematurity or premature injuries, and, in the worst cases, can be fatal.

Meghan and Nathan were referred to The Chicago Institute for Fetal Health (CIFH) at Ann & Robert H. Lurie Children’s Hospital of Chicago. The Chicago Institute is one of only a few comprehensive fetal centers in the country and specializes in the research and care of people with complex pregnancies. When the couple arrived at the institute for a full day of consultation and testing, Meghan and Nathan were nervous and uncertain, but quickly felt comforted by the reputable team.

On November 14, 2020, Meghan underwent a selective fetoscopic laser photocoagulation (SFLP), a minimally invasive laser surgery. During this surgery, the mother is lightly sedated and stays awake while fetal surgeons use a small camera to locate and seal the abnormal blood vessel connections in the placenta to prevent transfer of blood between fetuses which slows or halts the TTTS.

During the procedure, led by Dr. Aimen Shaaban, Director of The Chicago Institute for Fetal Health and an expert in fetal intervention surgery, the team realized that they would not be able to successfully reconnect all the blood vessels. They quickly pivoted to an alternate technique to drain the excess fluid and prioritize the safety of Meghan and her babies. Meghan and her unborn babies came out of surgery healthy, and she and Nathan felt comforted by the team’s quick decision-making.

Meghan stayed at the hospital for a couple of days after her procedure and followed up multiple times a week for routine monitoring. At 28 weeks, Meghan’s water broke, so she headed to Prentice Women’s Hospital, connected by a bridge to Lurie Children’s. With the help of her doctors, she was able to comfortably wait another five days before going into labor. On December 6, 2020, Meghan and Nathan welcomed Charlie and Kai into the world.

The boys were delivered through a caesarean section and quickly transferred to the neonatal intensive care unit (NICU). Born prematurely, the twins had a long journey ahead, but luckily, they had a world-class team supporting their development.

“The nurses and doctors became like family to us,” said Meghan. “They helped us understand what all the beeping and monitors meant and made us feel calm as new parents.” The couple received tremendous support from their care team while visitation was limited due to COVID-19. Meanwhile, Charlie and Kai continued to grow in the NICU.

During the twins’ last month in the NICU, physicians noticed that Kai’s head was developing abnormally, and specialists diagnosed him with craniosynostosis, a condition in which the brain matter starts growing into areas where the skull has yet to close and results in an abnormally shaped head. Charlie had not shown any symptoms of craniosynostosis, but being an identical twin, specialists decided to run a scan to confirm their suspicions and diagnosed both twins with the condition. This diagnosis meant that the twins would need to undergo another procedure.

At three months old Charlie and Kai were discharged from the NICU and ready to go home. They spent two months at home growing and gaining strength before they would undergo minimally invasive surgery to treat their fetal craniosynostosis.

On April 23, 2021, the family came back to Lurie Children’s and the twins underwent surgery with neurosurgeon, Dr. Arthur Dipatri, and plastic surgeon, Dr. Noopur Gangopadhyay. Following the successful surgery, they returned home the next day to recover and at two weeks post-surgery, began wearing helmets to help their skulls continue to develop correctly.

Today, Charlie and Kai are thriving and were recently approved to stop wearing their helmets. Last year, the family took a trip to Australia to meet Nathan’s family, a vision that had kept Meghan and Nathan hopeful throughout this process. Meghan and Nathan said, “Having a vision for the end of all of this was what got us through it.”

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