Triplets Thriving Following ‘Rocky Start,’ Including Fetal Intervention Procedure
When Brooke and Charles watch their triplet toddler boys wrestle, play and climb, as Brooke says, “on anything and everything,” it can feel like the rocky start the almost two-year-olds had before they were born was a lifetime ago.
Brooke was about 16 weeks pregnant when her maternal-fetal medicine provider at Northwestern Medicine/Prentice Women’s Hospital urgently referred her and her husband to The Chicago Institute for Fetal Health at Lurie Children’s. A routine ultrasound revealed that there was decreased blood flow through the umbilical cord of one of the babies, causing that baby to not grow as well as expected.
Less than a week later, the couple visited The Chicago Institute’s center inside Lurie Children’s. Brooke underwent a series of scans and tests before meeting with Dr. Aimen Shaaban, fetal intervention specialist and director of the Institute, along with several members of his team. It was then the couple was made clear about their options and the gravity of their situation. While compassionate and thorough, the team told them that intervention was likely needed for the best chance of survival of all three of their babies.
“It was an awful day emotionally and physically, but the team was absolutely incredible,” Brooke recalls. “They made us feel like we were the only patients they had to see that day.”
Brooke had a condition called selective intrauterine growth restriction (sIUGR). One placenta was being unequally shared by two of the triplets, restricting the growth and overall health of one of them (then known as Baby A) and threatening the health of the other (Baby B).
The best chance for the well-being of all three fetuses was for Brooke to undergo a minimally invasive procedure in which Dr. Shaaban would lead a team in the operating room to separate, using a laser, the placenta shared by two fetuses. This would help regulate the blood flow between the two. The procedure is optimally performed at 18-22 weeks gestation and is often done for patients with a diagnosis called twin-twin transfusion syndrome.
Brooke and Charles decided to move forward with the procedure less than a week later, when Brooke was 18 weeks pregnant. Following two weeks of bedrest, Brooke, an attorney, returned to “work and life,” she said, until she was 27.5 weeks pregnant, and she was admitted to the hospital after she developed an amniotic fluid leak.
Brooke made it to 30 weeks before delivering her boys – all three of them. Baby A, or Grayson, the triplet who faced the most challenges in utero, was born at one pound, 12 ounces. The other two, Jack (Baby B) and Robbie, were both under three pounds.
Still, despite the early arrival, none of the boys needed special intervention other than oxygen support without intubation. After 8 weeks in the neonatal intensive care unit at Prentice Women’s Hospital, all the boys went home with Brooke and Charles.
“It was huge,” Brooke said. “The best outcome we could’ve asked for.”
Today, the energetic boys are “normal toddlers” with big personalities and lots of energy, Brooke said. Grayson is small for his age, and he and Jack required some early intervention for gross motor skills. But all three boys are “extraordinarily healthy considering their rocky start,” Brooke said.
Looking back, Brooke said she’ll never forget the uncertainty and fear she and Charles felt sitting in the institute waiting room almost two years ago. But the team’s compassion, knowledge and approach made the intolerable situation manageable.
“We were in the best possible hands,” she said.
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