The news that she was pregnant was an exciting surprise for Karen, her husband Tom, and their sons, 12-year-old Greg and 9-year-old Ethan. When their ultrasound technician told them they were pregnant with twins they couldn’t believe it. “I had joked with my husband that we were having twins, so imagine our shock when we found out we actually were,” recalls Karen.
At their 12-week ultrasound the couple found out that the twins were identical, and their doctor mentioned that that put them at risk for Twin to Twin Transfusion Syndrome (TTTS). “He told us about the condition and said he would carefully monitor us for it,” says Karen. “At 22 weeks I felt as if I had popped out,” she remembers. An ultrasound revealed possible TTTS and Karen was immediately admitted to her home hospital, St. Francis Hospital in Peoria, IL.
“I felt as if my world had turned upside down, and I was scared at what the future would hold. I was away from my older boys, and they were put in the care of grandparents,” she says. After being admitted to the hospital, Karen’s Maternal Fetal Medicine Specialist (MFM) shared three treatment options with them.
The couple opted for laser surgery at the SSM Health St. Louis Fetal Care Institute. Karen was discharged from the hospital, and the couple headed to St. Louis after making one stop. “We stopped to try to explain the situation to our boys. We told them there was a complication with the babies, and that we may lose one or both babies but that the surgery was the best option,” recalls Karen. “My nine year old looked to us and said he hoped we came back with both babies, and that he would pray for us.”
When the couple arrived in St. Louis the Fetal Care Institute team had a variety of appointments arranged to assess the complicated situation. After learning more about all of their options, and making some difficult decisions, Karen and Tom decided to move forward with Fetoscopic Laser Photocoagulation Therapy for TTTS. Karen was 24 weeks pregnant when she had fetal surgery.
Fetoscopic Laser Photocoagulation Therapy is used in severe cases of TTTS, Stage 2 or higher, at approximately 16-26 weeks of gestation. Surgeons use a laser to block the placenta’s blood vessels that communicate between the two fetuses. The surgeon inserts a pencil-tip-sized telescope in the mother’s uterus and examines the entire placenta to find the crossing blood vessels. Once these are all mapped, a tiny laser fiber is inserted and laser energy is used to stop the blood flow between the twins. Separating the twin blood flow is like functionally separating the placenta, allowing each twin to develop independently.
“Surgery went well, and I was sent home to be a ‘slug’ for a week then return to the St. Louis Fetal Care Institute for an ultrasound. I had severe anxiety about what the ultrasound would show. Prayer got us through,” explains Karen. Over the next few weeks, the babies continued to healthily develop.
Since Karen lives in Clinton, Il., a two and half hour drive away from the Fetal Care Institute at SSM Cardinal Glennon Children’s Hospital in St. Louis, her care plan was to alternate her weekly check-up visits between the Fetal Care Institute and St. Francis Hospital in Peoria. Over the next few weeks, Karen’s high blood pressure led her to a few nights in the hospital for observation. At her 33-week appointment doctors were concerned about the health of one of her babies, so they admitted her to the hospital for the remainder of the pregnancy.
“On October 15, just after my breakfast was delivered, the doctor arrived to tell me not to eat or drink anything because we were going to have the babies,” says Karen. “Our goal was to make it to 36 weeks, and we made it to 35 weeks and 5 days.” “I was excited, but also nervous about the condition of the babies,” recalls Karen.
A few hours later 5 lb. 6.6. oz. Cari, and 4 lb. 2 oz. Cami made their entrance to the world via a Cesarean section. “Miraculously, they didn’t need to go to the NICU, and within 12 days both girls were home with us,” she says. The whole family is enjoying having the girls at home, “Their big brothers are so excited and doing well helping out,” says Karen. “We learned so much through this experience. You never know how strong you are, until being strong is the only option you have. This strength has led us to be blessed with two little miracles,” she says.