Twin Girls Thrive Thanks to Expertise in Fetal Surgery

June 14, 2018

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Twins Amara and Ariella with big brother Micah

In July 2017, Kimberly Husko and her husband Jeremiah were excited to learn they were expecting twins. Their excitement soon gave way to confusion when a routine ultrasound test four months later during Kimberly's second trimester indicated something unusual: the ultrasound couldn't detect "Baby B"'s bladder.

"We had no idea what it could mean," says Kimberly. "We were just anxiety-ridden."

Kimberly and Jeremiah were referred to The Chicago Institute for Fetal Health at Lurie Children's. There, Kimberly underwent additional tests which indicated that the twins were suffering from twin-to-twin transfusion syndrome (TTTS), a prenatal condition in which twins share unequal amounts of the placenta's blood supply, resulting in different growth rates. If left untreated, the condition can result in extremely premature birth or even death to at least one twin.

The Huskos met with the Institute's Medical Director, surgeon Aimen Shaaban, MD, and other staff, including a team social worker.

"We saw the scans, which showed how Baby B was being affected," says Kimberly. "Her amniotic sac was encasing her because she had no fluid around her. It was shrinking."

Dr. Shaaban explained that "Baby A" was receiving too much blood flow, while Baby B was receiving too little.

"The blood vessels were reaching across the placenta and forming abnormal connections between the babies," says Dr. Shaaban. "The condition was starting to affect Baby B's heart, posing high risks to both twins if not treated soon."

Dr. Shaaban recommended Kimberly undergo a laser separation procedure to correct the unequal blood flow. Dr. Shaaban, a fetal surgeon, is trained to perform this procedure, which results in a 94 percent chance that one twin will survive, and an almost 80 percent chance that both will survive.

Kimberly and Jeremiah had less than 48 hours to make a decision about going ahead with the procedure, which would take place at Lurie Children's. Ultimately, they decided to put their trust in Dr. Shaaban's expertise.

Kimberly had never undergone surgery. She says that the procedure was so quick that she thought she was still being prepared for the procedure when in actuality Dr. Shaaban had finished.

She stayed overnight in the hospital while a team of clinicians observed her and the twins. Everything went smoothly, and by the next morning, Baby B was already producing urine and amniotic fluid.

"We have refined the technique so that we can selectively operate on the vessels that are causing the unbalanced blood flow in the placenta," says Dr. Shaaban. "Laser separation is a highly successful procedure."

Last February, Kimberly delivered the twins at just over 33 weeks via C-section at Prentice Women's Hospital, which is connected by a bridge to Lurie Children's. Amara (Baby A) weighed 4 pounds, 1 ounce, and Ariella (Baby B) was 3 pounds, 7 ounces. For three weeks the twins stayed in the Prentice Neonatal Intensive Care Unit, which is staffed by Lurie Children's neonatologists and neonatal nurses, and were able to go home at the same time.

Today, the twins are thriving, and both have more than doubled in weight.

"We've come quite far from where we've been," says Kimberly. "Without the fetal medicine team at Lurie Children's, we would not be holding our baby girls today."