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Fetal Care

 Twins Thriving After Life-saving Surgery

  At first glance, Teela Wells appears to be your average busy mom. She has a stroller carting handsome twin boys, a seemingly bottomless diaper bag and a 4-year-old son keeping a watchful eye on his younger siblings.

But the fact that Teela can have these everyday experiences with her family is nothing short of miraculous.

Teela and her twins are patients of the St. Louis Fetal Care Institute, located at SSM Cardinal Glennon Children’s Medical Center and SSM St. Mary’s Health Center. The St. Louis Fetal Care Institute is the only comprehensive fetal therapy program in middle America.

Twins Aidan and Adrian were diagnosed with Twin-Twin Transfusion Syndrome in the womb. Twin-Twin Transfusion Syndrome is a disorder in which one twin receives too little of the shared blood supply, while the other twin receives too much. This devastating disorder too often brings tragic outcomes.

Left: Teela Wells and her family

"Usually both twins die," said fetal surgeon Ed Yang, MD, Ph.D., co-director of the St. Louis Fetal Care Institute. "If one twin dies, there is a very high risk of the other twin dying or having brain damage due to the toxins released by the twin who dies."

When Teela initially learned her diagnosis, she prepared herself for the worst.

"It was scary enough having twins, and then this—it was overwhelming," Teela said. "My mom said I could have come home with either one or none (of the twins). I am so thankful I came home with two."

The mortality rate with Twin-Twin Transfusion Syndrome can be as high as 80 percent.

But for moms who catch the diagnosis in time, comprehensive fetal centers such as the St. Louis Fetal Care Institute can provide life-saving interventions.

Teela and her babies were closely monitored by Dr. Yang and Mike Vlastos, MD, maternal-fetal specialist and co-director of the St. Louis Fetal Care Institute. Nurse coordinator Katie Francis, CPN, was with Teela through every step of the process. For Teela, this team approach and willingness to listen set the team apart from others.

Right: Dr. Vlastos and Dr. Yang during a follow-up visit with the twins

"A lot of times, people will tell you something medical and you leave the office and still don’t know what they’re talking about," Teela said. "My doctors broke it down and always made sure I understood things. They gave me the opportunity to go home and think about it."

In November, Teela and her twins underwent an advanced fetal procedure called laser ablation. The laser ablation separates the shared blood cells, correcting the imbalance of blood flow between the twins. This procedure is done using a laser and minimally invasive fetoscope the size of a spaghetti strand.

The procedure was a tremendous success and on Feb. 22, Aidan and Adrian were born. After a short stay in the Level III neonatal intensive care unit at SSM St. Mary’s, the babies were ready to go home with their mom.

"It’s the best feeling ever, to intervene and really change the course in a disease that is uncommon in obstetrics," Vlastos said.

Teela thinks so too.

"They are getting bigger and eating more," Teela said. "Everything is looking good."