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High-Risk Pregnancy

When it's bedtime for two-year-old twins Lydia and Thea, their Beanie Babies always bring them comfort. For Amy, a second-grade teacher from Powell, Ohio, and her husband Mike, those stuffed animals mean something very different. It's difficult to believe that the girls were the same size as those Beanie Babies when they were born at 30 weeks. What's even more unimaginable is that when Amy experienced multiple, rare pregnancy complications, these two vivacious little girls almost didn't survive.

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A ROUTINE ULTRASOUND BECOMES DIRE

"When you're diagnosed with a high-risk pregnancy, you're thrown into this world that you aren't prepared for."

When Amy and Mike went for an ultrasound at 20 weeks, they were excited to find out if they were having boys or girls. When the ultrasound technician went to get the doctor, however, they knew that they were about to get bad news.

The diagnosis was Twin-to-Twin Transfusion Syndrome (TTTS), a rare pregnancy complication that gives one baby all of the mother’s nutrients and essentially starves the other baby of the nutrition it needs to develop.

Amy's OB/GYN immediately referred the couple to Dr. Richard O'Shaughnessy, a maternal fetal medicine specialist at The Ohio State University Wexner Medical Center. Before meeting with Dr. O'Shaughnessy, Amy and Mike did extensive online research and contacted the national Twin-to-Twin Transfusion Syndrome Foundation. The Foundation told the couple that there were only two doctors in Ohio with the expertise to surgically treat TTTS. One of those physicians was Dr. O'Shaughnessy.

 

COMPLEX LASER SURGERY SAVED HER TWINS

"We had one of the best doctors in the country for what we were facing."

From the minute Amy and Mike met "Dr. O," as they affectionately call him, they knew he would give them the best chance at saving both Lydia and Thea. Dr. O'Shaughnessy counseled the couple about their treatment options, and Amy and Mike opted for the laser treatment. Dr. O expertly performed the delicate surgery that treated the nutritional imbalance, and within one day, both babies were doing much better.

When they thought they were in the clear, Amy and Mike got more bad news. During an ultrasound to monitor the girls' functioning, the technician discovered a problem with the girls' blood flow. Thea's blood was too thick and Lydia's blood was too thin, a condition called Twin Anemia-Polycythemia Sequence, or TAPS.

For nearly two months, Dr. O'Shaughnessy painstakingly performed in-utero blood transfusions to level out the girls' hemoglobin levels, until Lydia and Thea were developed enough to be delivered by C-section at 30 weeks.

SHE NOW CONSIDERS OHIO STATE FAMILY

"Ohio State became family, and we became family to them."

After 50 days of expert care in the Level III NICU, the highest level of intensive care available to newborns, Amy and Mike happily took their twins home. Today, Amy is doing fine and the girls are healthy, happy and above the developmental milestones for their age.

When Lydia and Thea turned two, their birthday party was filled with close family and friends. While not all of the doctors and nurses at Ohio State's Wexner Medical Center who helped make this birthday celebration possible were able to attend, they were definitely there in spirit.

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Meet Amy's Care Team

Behind every patient story we feature are the people who made it a success. Learn more below about Amy's talented care team.

Dr. Richard O'Shaughnessy

Dr. Richard O'Shaughnessy

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Dr. Richard O'Shaughnessy, Maternal Fetal Medicine Specialist at Ohio State

Dr. O'Shaughnessy was Amy and her husband Mike's high-risk pregnancy specialist at The Ohio State University Wexner Medical Center.

Dr. O'Shaughnessy shared with Amy and Mike the diagnosis of Twin-to-Twin Transfusion Syndrome (TTTS) and promised to be there to guide them through the process.

"Dr. O," as the couple affectionately calls him, is one of only a few specialists in the nation with the expertise to surgically treat Amy's rare pregnancy complication.

Amy and Mike see Dr. O'Shaughnessy as their family and respectfully refer to him as a fighter for their unborn babies.

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Dr. Britton Rink

Dr. Britton Rink

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Dr. Britton Rink, Maternal Fetal Medicine Specialist at Ohio State

Dr. Rink worked closely with Dr. O'Shaughnessy to help care for Amy's twin girls during her pregnancy.

Amy continues to be touched by Dr. Rink's positive and energetic outlook for the future of her twins.

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Karen Rossi, RN

Karen Rossi, RN

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Karen Rossi, RN, Maternal Fetal Medicine Nurse

Karen was Amy's nurse and was an integral resource throughout the care process, even being available 24/7 to answer Amy's questions or address her concerns.

Amy jokingly refers to Karen as "the whip" because of her take-charge attitude and the fact that she took care of everyone.

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Thankfully, most pregnancies go smoothly and most babies are born healthy. But, if a complication should arise, the team at The Ohio State University Wexner Medical Center stands ready to assist you with a variety of programs to meet your unique needs.

Some more common factors that contribute to a high-risk pregnancy include being pregnant with multiples, diabetes, genetic conditions, history of premature births, advanced maternal age or any condition the mother or baby presents that could require high-risk care or fetal treatment.

High-level targeted ultrasounds and screenings such as amniocentesis, chorionic villus sampling, fetal blood typing and fetal echocardiogram can help diagnose fetal abnormalities and other high-risk pregnancy issues.

If your primary OB/GYN referred you to Ohio State's Maternal Fetal Medicine for advanced maternal fetal care, we will work hand-in-hand with your primary OB/GYN to monitor your care and make sure that you are receiving exactly what you need, when you need it.

Ohio State's Wexner Medical Center is committed to providing women convenient and comprehensive care for every stage of life. The latest "America's Best Hospitals" issue of U.S. News & World Report recognizes our gynecology/women's health program as being among the best in the country.

What is Twin-to-Twin Transfusion Syndrome (TTTS)?

Twin-to-Twin Transfusion Syndrome (TTTS) occurs in 5%-15% of identical twins and is diagnosed by a high-risk obstetrician using ultrasound. This is a complication affecting a small number of identical twins in which the twins are sharing one placenta unevenly. One baby acts as the "recipient" of too much blood and the other becomes the "donor" receiving less blood (and therefore less nutrients) from the placenta. This uneven sharing causes problems for both babies.

Weekly ultrasound measurements of growth, fluid levels, the function of the fetal hearts and blood flow through the umbilical cords are used to determine how severe the problem is and to decide if treatment is needed.

Treatment

When choosing treatment options, Ohio State considers the unique characteristics of each pregnancy and approaches a care plan step-by-step to minimize risks. Some of the TTTS treatments available are:

  • Amnio-reduction removes excess amniotic fluid with a thin needle. This procedure has the lowest risk.
  • Laser photocoagulation of the placental vessels uses laser energy to interrupt connecting blood vessels on the surface of the placenta, allowing each fetus to have its individual blood supply. This outpatient surgery is performed only at qualified fetal centers in the United States, such as The Ohio State University Wexner Medical Center. In fact, Ohio State's Maternal Fetal Medicine program is home to one of only a few specialists in the nation with the expertise to perform this laser surgery. This procedure has more risk, but studies show it may be more effective in treating the cause of the disease.
  • Bed rest: Since a decreased level of activity is often recommended, bed rest may be suggested as a treatment. The recommended level of activity may change as the pregnancy changes.

When experiencing a high-risk pregnancy you should select a facility, such as the OSU Maternity Center, that offers a Level III—the highest level—Neonatal Intensive Care Unit (NICU). This means should your baby require special care after delivery, our team has been trained in the latest advances in neonatal care. You can take comfort in the fact that should the unexpected happen, our team is prepared.

Learn More

To schedule an appointment with Ohio State's Maternal Fetal Medicine, consult your primary OB/GYN and ask him or her to schedule an appointment at 614-293-2222.

Ohio State Expertise

The Ohio State University Wexner Medical Center’s Maternal Fetal Medicine program has a rich tradition of excellence and leadership in patient care, research and the education of future leaders in the field. U.S.News & World Report consistently recognizes our expert physicians as being among "America's Top Doctors," and we have four out of the magazine's five "Ohio's Top Doctors" in perinatology.

Ohio State's Maternal Fetal Medicine team is the region's leading team of high-risk prenatal specialists. Our specialists are dedicated to working with you and your obstetrician to deliver the very best care possible and, of course, peace of mind. Our highly trained, multidisciplinary team provides access to the most advanced diagnostic procedures and treatments while providing the individualized approach to care that revolves around you and your baby.

Your care is managed by our nationally and internationally recognized team of specialists, many of whom have been designated as some of "America's Best Doctors." As a patient, you benefit from specialists who are also trained in teaching. Many are editors and authors of textbooks that are utilized daily in obstetric care throughout the United States.

Our specialized programs include one of the top five largest Diabetes in Pregnancy programs in the country, preterm birth prevention, genetic counseling, the only fetal treatment program in central Ohio and the only maternal fetal medicine specialist in central Ohio offering treatment for Twin-to-Twin Transfusion Syndrome (TTTS).

Thirty Years of Ohio State's Maternal Fetal Medicine

For more than 30 years, our specialists have advanced the nation's obstetrical care through innovations such as controlling gestational diabetes, identifying the only two clinically useful risk markers for premature birth (cervical length and fetal fibronectin), managing long-term needs of hypertension in pregnancy and advancing in-utero fetal surgery.

At the area's only comprehensive maternal fetal medicine program that is part of an academic medical center, our patients and their obstetricians have access to and are able to apply the latest research and the best practices, many of which were developed and refined right here at The Ohio State University Wexner Center. That means we can detect problems faster, intervene earlier, treat more effectively and manage care more efficiently, so you can expect the best.

In addition, when it comes to high-risk pregnancies and deliveries, we are prepared. We operate a large Level III nursery, and our Level III Neonatal Intensive Care Unit (NICU), the highest level of care, means we're qualified to handle deliveries with special circumstances, such as the birth of multiple babies. We're staffed with many specialists in-house, including neonatologists, who specialize in newborn infant care. So even if you're having a normal pregnancy, if an unexpected need should arise, you can rest easier knowing we're prepared to handle it.

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