GRAYSLAKE – Twins were the last thing Kimberly Husko expected when she found out she was pregnant last year.
It had been a joke during her first pregnancy. Her husband, Jeremiah, had fraternal twin sisters, and when she became pregnant with their son, Micah, he would jokingly ask her what she would do if there were two babies instead of just one.
“We had the thought that we’d have two and then we’d be done,” Husko said. “One kid per parent. We could manage that.”
The second time around, during their first ultrasound, the Grayslake couple found out that they were, in fact, expecting identical twins.
“I told him it was his juju that put it out there,” Husko said. “He kept joking about it.”
The couple quickly – and excitedly – had to come to terms with the fact that they would be going from a family of three to a family of five. It was the last thing they expected.
Well, the second-to-last thing.
The last thing they expected was how quickly a routine ultrasound would land Husko and her twins in emergency fetal surgery in just 48 hours.
Husko’s second trimester brought an end to the horrible morning sickness she had experienced for the first 12 weeks, and also brought the exciting news that the twins were two girls. With the morning sickness gone, Husko anticipated a smooth pregnancy, much like the one she had experienced with Micah. So when the ultrasound technician told her that she needed to come back in a week for another ultrasound, she didn’t read too much into it, but the doctors already were noticing potential problems with Baby B’s development.
“They would scan the bladder and they wouldn’t see [it] sometimes, which means it wasn’t filling up,” Husko said.
Her Lake Forest doctors explained to her this was a sign of a disorder called Twin to Twin Transfusion Syndrome and referred her to the Chicago Institute for Fetal Health at Lurie Children’s Hospital in downtown Chicago.
The doctors at Lurie told Husko that they wanted her to come down immediately for more screenings to see how serious her case of TTTS was, “which again was kind of a shock. You go from zero to 60, not realizing ‘OK, it’s that serious where I need to come down [immediately].’ They called on a Monday, and I went down on a Tuesday or Wednesday.”
Twin to Twin Transfusion Syndrome is a disease that “occurs primarily and almost exclusively in identical twins that share one placenta … but yet they’re in two separate amniotic bubbles,” explained Dr. Aimen Shaaban, the director of Lurie’s Institute for Fetal Health and Husko’s doctor when she arrived at the hospital downtown.
Ten percent to 15 percent of identical twin pregnancies develop this disease, which can be fatal to one or both babies if no medical intervention is done quickly enough. In most twin pregnancies, a network of connections in the placenta distributes the proper amount of blood flow to each baby through the umbilical cord. TTTS occurs when short circuits in that network distribute too much blood flow to one baby and too little to the other.
The baby with too little blood flow doesn’t develop properly because of its decreased circulation and doesn’t create enough urine, thus decreasing its amount of amniotic fluid.
“Over time, that baby can get very sick and can die from too little blood flow,” he added.
Meanwhile, the larger baby gets too much blood flow, which poses its own risks: The increased circulation and higher levels of amniotic fluid cause the heart to work a little bit harder.
“Over a long period of time, that heart can develop a heart thickening and failure and eventually that baby can die from that condition,” he said.
TTTS progresses in five stages. After additional tests and screenings at Lurie Children’s Hospital, Shaaban informed Husko and her husband that her twins were at stage three. He presented them with their options, including his personal recommendation of a cutting-edge laser surgery to identify and eliminate the short circuits that were causing the imbalance of blood flow from the placenta to the babies.
They had 48 hours to decide.
“It was a pretty big, drastic shift in things,” Husko said. “That night, I talked to my husband because they said, ‘OK, we would suggest you have this procedure within the next 48 hours to have the success you want it to be and not have an issue with either baby.’”
Ultimately, Husko opted for the procedure. While Dr. Shaaban had performed the procedure many, many times before at his previous hospital in Cincinnati, Husko would be the first patient in his care to under the procedure at Lurie’s Children Hospital.
The procedure lasted roughly an hour and a half and within 24 hours, doctors already began seeing improvements in the Baby B’s urine output.
Then on Feb. 26 – the day before Husko’s birthday – Ariella and Amara were born at 33 weeks and five days, weighing in at 3 pounds, 8 ounces and 4 pounds, 1 ounce respectively.
The twins spent 22 days in the NICU, but were eventually sent home with no further issues. Today, Ariella – Baby B – weighed in at 11 pounds at her last wellness check, while her sister just cleared 12 pounds.
Husko and her husband have settled into the (sometimes chaotic) life of having two newborns and a soon-to-be 2-year-old and are relieved to have that entire ordeal behind them.
“I would say we were lucky because everything that I’ve read about one, having NICU babies in general and babies born as early as they were born and the TTTS together, there are people who obviously were not as successful,” Husko said.
She added that she was grateful for Dr. Shaaban and his approach to their situation.
“I really enjoyed Dr. Shaaban and his approach and just his personality and how he gave us the overall diagnosis,” she said. “It was just the facts. Here’s the images and this is what this means and here’s your choices.”
Shaaban joined Lurie Children’s Hospital last year to head the hospital’s Institute for Fetal Health and said the program has had a major impact for local patients, especially.
“Moms that were previously either leaving town and going far, far away and relocating sometimes for weeks or months … now have access right here. Right here,” he said. “And they can drive and they can go home. They can sleep in their own beds, sustain their own lives, maintain their own jobs, take care of their own families. So that has an immediate impact.”
“And it happened,” he added, “because the leadership of our hospital is visionary and they are holistic in their approach to giving care and have ceaselessly and very honestly bested themselves in this project.”