Weathering the storm

Twins born healthy after life-threatening condition in utero

GONZALES — On a recent weekday afternoon, identical twin sisters Aubrie and Kenzie Jacob, about 2 months old, slept serenely in their carriers, one little girl dressed in pink, the other in green.

Perfectly healthy now, they were unaware that before their birth they were in the center of a virtual firestorm of medical intervention, urgent travel and unexpected surgery that all happened within a number of hours when they were still in the womb, almost three months before their birth on May 15.

But the crisis has passed, and the girls are leisurely embarking on the pursuit of wrapping everyone around their little fingers.

“After about the first three days of initial shock” having twins seems perfectly normal now, dad Lance Jacob, of Galvez, said.

On Feb. 24, mom Brianna Jacob learned that the twins were developing what’s called Twin-to-Twin Transfusion Syndrome (TTTS), a potentially fatal condition that affects some identical twins, as Kenzie and Aubrie are.

In the womb, identical twins may each have an amniotic sac, but share one placenta, said Dr. Michael Belfort, obstetrician and gynecologist-in-chief at Texas Children’s Hospital in Houston, who led a laser procedure that corrected the life-threatening condition for the twins.

In such cases, blood is normally shared between the twins, through some common blood vessels in the placenta, in a back-and-forth way, Belfort said.

But in about 15 percent of cases “there is a net transfer of blood between them,” meaning that one baby doesn’t receive enough blood, while the other receives too much,” he said.

“If you do nothing about it, about 90 percent (of the time), both babies die,” Belfort said.

He credits Brianna Jacob’s doctor, Dr. Marshall St. Amant, chief of maternal fetal medicine at Woman’s Hospital in Baton Rouge, for catching the condition early.

It was St. Amant who, at one of Brianna Jacob’s regular checkups, discovered the condition and arranged for her to be admitted at Texas Children’s Hospital that same evening, Brianna Jacob said.

An ultrasound showed that baby Aubrie had five times the amount of fluid in her amniotic sac as sister Kenzie had, Brianna Jacob said.

The day of the diagnosis, Lance Jacob, who does installation and repair work for a phone company, said he was “knocking on someone’s door at 3:30 p.m. (on the job). At 3:45 p.m., I was driving to Houston.”

In Houston, the couple was met by three surgeons, two nurses, an admissions nurse and an anesthesiologist, Brianna Jacob said.

Brianna, who was sedated but conscious, went into surgery shortly before midnight. She was 24 weeks pregnant.

The procedure took about an hour, but “felt like six years,” Lance Jacob said.

The treatment for Twin-to-Twin Transfusion Syndrome is laparoscopic laser surgery that burns closed the placenta’s connecting blood vessels between the babies, Belfort said.

“It’s been done for almost 20 years now,” Belfort said of the procedure. “It’s been growing in popularity a number of years to become the standard treatment,” he said.

Back home in Galvez, the pregnancy continued without further undue drama for Brianna and Lance Jacob.

At one point, Brianna began having some early contractions and was hospitalized for two nights, and, in general, took it easy and rested, she said.

The babies were delivered by scheduled cesarean section at around 35 weeks on May 15 at Woman’s Hospital: Kenzie weighing 4 pounds, 11 ounces and measuring 18 inches long, and Aubrie weighing 4 pounds, 12 ounces and measuring 17.5 inches long.

These days both girls are more than 8 pounds.

The couple’s little girls “take turns: One week, one is fussy and the other is passed out; it switches every five days,” Brianna Jacob said.

Especially in the beginning, mom and dad and the whole family got a little confused about how to tell the twins apart, but have come up with ways to keep the girls’ identities straight, with dress colors, for instance.

“For a while, when we first got home, it was ‘this one’ and ‘that one,’” Lance Jacob said.