Sharing the same amniotic sac and occurring in less than 1 percent of all U.S. twin pregnancies, monoamniotic twins carry serious risks — including cord entanglement, which can cut off the blood flow from the placenta to the fetus. With Kate and Annie, the girls’ cords created a tight knot and their heart rate was dropping — leading to an emergency cesarean delivery at Packard Children’s.
“Having a set of monoamniotic twins can be dangerous and unpredictable,” said Susan Crowe, MD, who led the delivery team and noted that around 20 percent of these twins die from complications. “With no membrane dividing them, the obstetrician has to balance the risk of prematurity with the risk of a cord event,” Crowe said.
As first-time parents, Allison and Kevin were thrilled to learn that Allison was pregnant with twins. While their excitement quickly turned to a bit of fear when they learned about the dangers involved with monoamniotic twins, they were comforted knowing that the Center for Fetal and Maternal Health specializes in high-risk pregnancies.
Jane Chueh, MD, director of prenatal diagnosis and therapy, and the obstetrical team guided Allison from the day she arrived at Packard Children’s in October through the weeks leading up to the girls’ emergency delivery – making sure that she got the care needed to assist the day-to-day growth of the twins. But, the fateful November 7 day came when doctors determined that the twins’ decreasing heart rate required they enter the world immediately – about 10 weeks before the babies would hit a full 40-week term.
Neonatologist William Rhine, MD, was among those caring for the preemies once they were successfully delivered and arrived in the Neonatal Intensive Care Unit, where the babies – weighing in at just 3 pounds for Kate and 3 pounds, 2 ounces for Annie – began life. “It was a testimony to the skill of the obstetricians to allow the twins to grow in the womb as much as they did,” Rhine said.
Now, as the girls approach their first Christmas and a date to go home to Menlo Park, Calif., Kevin and Allison are looking forward to a low-key holiday with their new daughters – even if they spend it at the hospital helping the girls get healthier.
“We’re really grateful,” Kevin said. “Despite the chaos surrounding our delivery and pregnancy, Packard Children’s really put us at ease with their experience and expertise. It’s one of the best holiday gifts a family could ever ask for.”
