When Siman Abdi returned to Minnesota after spending the summer in Kenya with her family, she didn’t feel like herself. She worried she may have malaria and went to her doctor. At her appointment, she learned that she didn’t have malaria – instead, she was pregnant. Her doctors coordinated an ultrasound for her that day, and the surprises continued. Siman was thrilled when her doctor told her she was seven weeks pregnant – with twins!
At a routine appointment around 20 weeks gestation, Siman’s ultrasound tech noticed something abnormal. Doctors from the Midwest Fetal Care Center confirmed twin-to-twin transfusion syndrome (TTTS), a rare condition that happens in about 10 to 15-percent of identical twins. It occurs when one twin donates blood to the other while in the womb, so one baby has too much blood (recipient baby) and the other doesn’t have enough blood (donor baby); and it’s life-threatening for both. Her doctors said she’d need in-utero fetoscopic laser ablation surgery, which blocks the transfer of blood between babies. Siman was scheduled for surgery the next day, and it was a success.
After surgery, Siman’s goal was to get the pregnancy as far along as possible. She had weekly doctor appointments for an ultrasound, iron infusions and to drain built-up fluid, which improved her and the babies’ health. Doctors also began the betamethasone protocol, which helped develop the baby’s lungs to prepare for pre-term labor. Siman continued to feel sick throughout the pregnancy, but knew the longer she was pregnant the better it was for her babies.
At Siman’s 24-week appointment, she started contractions and checked into The Mother Baby Center. Four days later, on Feb. 11, 2014, doctors said she needed to deliver the babies. Siman learned that her babies would need to be stabilized immediately after birth, so she wouldn’t be able to see or hold them right away. The twins, Amina and Rania, were born that night. Each baby had a nurse waiting
to take them to the high-risk room next to Siman’s operating room, where they were quickly stabilized and intubated, which helped with their breathing. From there, they were taken to the Children’s Minnesota neonatal intensive care unit (NICU).
Amina and Rania spent several months in Children’s Minnesota NICU and Infant Care Center (ICC). Incredibly, they didn’t require any surgeries after birth. During their time in the NICU and ICC, both girls were closely monitored to make sure they were getting stronger and healthier, and received respiratory support as well as monitoring for other health issues.
Amina was the recipient baby (who received blood in-utero) and the stronger of the two, so she was able to go home in May. However, Siman wanted to stay in the hospital with Rania, so staff placed a second crib in the room so that Amina could stay there and Siman could be close to both of her daughters. “I can’t even put into words how much that meant to me, to be able to stay with both of my girls and keep them together,” said Siman “I was never away from them.”
Then in early June, Rania was discharged and both girls went home, without needing oxygen or other support. Rania used an apnea monitor for about a month after going home but quickly no longer needed it. The girls continue to work with Children’s Minnesota specialists on respiratory and vision issues, and are doing very well. Rania, the older twin by one minute, is quiet and thoughtful; while Amina is more rambunctious and playful. They are happy and joyful toddlers, who love spending time with their family, including their three older siblings.
As Siman exclaims, “their health today is nothing short of a miracle.”
Photo credit: Lynsey Tjaden