Trusting the Process: A Quick Turnaround Fetal Surgery for Twins

As a registered nurse, Elizabeth had the medical knowledge to know that something was wrong during her 18-week ultrasound. She knew she was expecting twins, but one twin had slightly higher levels of amniotic fluid than the other.

Elizabeth and her husband, Brandon, quickly became aware of the risks that can come with having more than one fetus. These risks included what ultimately was her diagnosis: the condition called Twin to Twin Transfusion Syndrome (TTTS). TTTS occurs when the complex blood flow from the placenta has abnormal connections, resulting in an imbalance in blood flow between the twins. This imbalance can result in poor growth for one twin and heart failure for the other twin with a risk for loss of one or both fetuses in utero.

To monitor the condition, Elizabeth started getting ultrasounds more frequently and by week 20, the amniotic fluid levels had become more out of range. The couple was referred to The Chicago Institute for Fetal Health at Lurie Children’s. They went for a consultation, where Elizabeth underwent various scans, and the couple had a meeting with a team of specialists, including fetal surgeon, Dr. Aimen Shaaban, Director of The Chicago Institute, along with a Maternal Fetal Medicine doctor, a Fetal Anesthesiologist, and a Fetal Nurse Coordinator. They talked in depth about the condition, the risks of waiting to see if it resolved on its own, and the risks involved with surgery. “They did not try to sugarcoat things,” she said, “We always felt super comfortable and in great hands. The team reassured us that the twins health was top priority.”

Within an hour they decided to go forward with surgery. “Surgery was a 48-hour whirlwind,” she recalls, “I had no idea it was going happen so fast.” Elizabeth, an optimistic person by nature, decided to trust the process. She and Brandon felt that there was a reason they were there that day. Despite not knowing what the outcome of the surgery would be, she recalled feeling calm as she was rolled to the operating room.

After surgery, she spent only one night at Northwestern Medicine Prentice Women’s Hospital. In the follow-up imaging several days after the procedure, it was evident that the amniotic fluid volumes had normalized indicating that the imbalance in placental blood flow had been corrected by the surgery. While the surgery was successful, the babies still needed time to develop. The specialists talked through what Elizabeth needed to do to remain safe for the remainder of the pregnancy so that the babies could have as much time as possible in utero, including getting plenty of rest.

Elizabeth carried the twins to term at 37 weeks, an incredible gestation for twins. The couple expected the twins to stay in the Neonatal Intensive Care Unit (NICU), but they were able to take Jackson and Harrison home after just three days. “Without The CIFH, we are not sure how well the twins would have done or if they would have even made it to the end of the pregnancy together.”

Now, at three years old, Jackson and Harrison are talking, playing, and going to school. They do not require any major follow-up appointments; they are healthy and happy. They love fire trucks, cars, and all things transportation. Not only are they talking, but they have inside jokes with each other and similar mannerisms.

In describing their twin bond, Elizabeth says, “I couldn’t imagine one without the other."

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