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Twin-to-Twin Transfusion Syndrome

Tom and Rochelle Jones, parents of a boy and a girl, learned that they were expecting twins. Rochelle's OB/GYN referred her to Lancaster General Health Physicians Maternal-Fetal Medicine for a 19-week ultrasound that would reveal whether the twins were boys or girls. The last thing they expected was to learn that something was seriously wrong.

During the scan, Rochelle and her husband noticed that one baby was very active, while the other hardly moved. Rochelle’s doctor explained that their girls had twin-to-twin transfusion syndrome (TTTS), a rare condition that occurs in identical twins, when the blood supply of one baby moves to the other through their shared placenta. Untreated, TTTS can be fatal to one or both babies.

“Aspen appeared to be shrink-wrapped to the uterus by the membrane, and she had little amniotic fluid around her,” recalled Rochelle.

Collaboration with Children's Hospital of Philadelphia

The couple was given a DVD about the condition and recommended they consult with surgeons at Children's Hospital of Philadelphia. Thanks to the collaboration between LG Health and Children’s Hospital of Philadelphia, Rochelle’s doctor was able to reach Children’s Hospital immediately and arrange for an appointment. Two days later, Rochelle went to Philadelphia for a day of testing to determine if she was a candidate for in utero laser surgery.

“My doctor in Lancaster said there were some treatment options here, but he preferred to send me to Children’s Hospital of Philadelphia, where some of the new procedures were pioneered,” said Rochelle. “I was so impressed with their communication. We didn’t have to worry about calling other doctors and making appointments or anything. That was the last thing that we needed to worry about at a time like that.”

Fortunately, Rochelle was a candidate for the procedure and four days later, a team of surgeons operated on the babies' placenta to balance the flow of blood. By morning, a follow-up ultrasound confirmed that the twin-to-twin transfusion syndrome was already starting to reverse and fluid was flowing to the baby that previously had none.

In the Nick of Time

Rochelle's surgery took place two days before Thanksgiving—timing that could not be more apt, given what the couple later learned. Had the condition not been caught when it had, the twins would have been lost. Twin-to-twin transfusion syndrome can occur at any point in a pregnancy, but there is a small window of time in which to detect and correct it.

After her surgery, Rochelle was put on bed rest for the next five weeks, with weekly ultrasound follow-ups at Maternal-Fetal Medicine to monitor the babies' progress.

“Throughout the monitoring, my doctor said it was amazing that the twins were equal in growth week-to-week. They were essentially identical in size,” Rochelle said.

The goal at the time of Rochelle’s surgery was to get her to 28 weeks gestation. The twins were delivered at Women & Babies Hospital at 36 weeks—full-term—and sent home without delay. Today, sisters Ainsley and Aspen are happy and healthy and right on target with their development. Their parents will always be grateful for their doctor's accurate diagnosis and quick action to get them the most advanced treatment available to save their daughters’ lives.

“We are so thankful for the hope that they offered to us down at Children’s Hospital of Philadelphia and just incredibly thankful for the work that they do, day in and day out. They save a lot of babies.”

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