Rare surgery saves woman's babies
Identical twins' lives were threatened by syndrome of unknown cause.
07/24/2011 12:00 AM
07/21/2011 9:56 PM
Everything seemed fine with Nicole Temple's pregnancy until she went for a routine ultrasound March 4.
An ultrasound technician at Carolinas Medical Center's Women's Institute in Charlotte found her twins' lives threatened by a rare abnormality called twin-twin transfusion syndrome. A just-as-rare surgical procedure had to be performed.
One of the twins was getting too much blood and was surrounded by an unusually large amount of amniotic fluid. The other twin wasn't getting enough fluid. Without the surgery, both would likely have died.
Temple, 26, of China Grove, is a certified nurse assistant at Lake Norman Regional Medical Center in Mooresville.
She was 17 weeks pregnant at the time of the ultrasound. Until their birth June 21, she identified her twins as Baby A and Baby B. She didn't know how she could handle it if she and her boyfriend, Cody Ingram, 28, had given them real names and one or both of the twins died, she said.
Identical twins Kory and Alex were saved by Dr. Courtney Stephenson, a maternal-fetal medicine specialist at CMC. She had spent part of two years learning a special laser technique from a Cincinnati doctor who is an expert on the procedure.
Since January, Stephenson, director of the Charlotte Fetal Care Center, has seen 19 patients with the syndrome and done 113 ultrasound evaluations for them.
Through a small incision in Temple's belly, Stephenson on March 9 inserted a camera that magnified the placenta and allowed the doctor to identify abnormal blood vessels. Stephenson had a team from CMC Women's Institute with her, including Dr. Albert Franco, a nurse and two ultrasound technicians.
Using laser energy, she cauterized the vessels and stopped the uneven blood flow, improving the balance of blood flow to each twin.
Within 24 hours, Temple said, an ultrasound showed her twins "were doing 100 percent better."
Temple continued weekly ultrasounds - 18 in all - until she gave birth by caesarian section at Lake Norman Regional. Drs. James Wilson, Teresa Melvin and James Al-Hussaini of Lake Norman Obstetrics & Gynecology in Mooresville consulted with Stephenson and Franco before the twins were delivered.
Kory Ingram was born at 8:28 p.m. June 21 at 3 pounds 6 ounces. Alex Ingram was born a minute later at 3 pounds 15 ounces. They were born after 32 weeks and six days gestation.
The twins are still in Lake Norman Regional's special care nursery, where Temple visits at least once a day. They are bottle-fed every three hours.
"They're making good weight gain," Temple told me during an interview July 7 at the nearby Starbucks. Kory was up to 4 pounds 1 ounce and Alex to 4 pounds 10 ounces.
The couple also have a son, Hunter, 4. Cody Ingram's son, Caleb, is 8.
Temple said the couple's parents, Bob and Kristi Temple of Mooresville and David and Janie Ingram of Kannapolis, have helped take care of Hunter and assisted with chores. Temple was put on bed rest after the March surgery until she gave birth. The couple's extended family also have helped.
By telling her story, Nicole Temple said, she hopes to raise awareness of the syndrome and the foundation devoted to finding its cause and cure, the Twin to Twin Transfusion Syndrome Foundation at www.tttsfoundation.org.
She also thanked the medical teams.
"I was so lucky to have the doctors I've had to get (the twins) to this point," she said. Because of them all, she said, her twins are here today.
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