What is a rainbow twin?

You've heard of a rainbow baby, a child born after the loss of a previous pregnancy or newborn. What's less common is having two rainbow babies in the same home. And even rarer than that? Two rainbow babies in a single pregnancy. When Caitlin Hinson learned she was pregnant with twins, she was ecstatic.

atriumhealth.org - Twin Rainbow Babies Beat the Odds – Twice - Atrium Health

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You’ve heard of a rainbow baby, a child born after the loss of a previous pregnancy or newborn. What’s less common is having two rainbow babies in the same home. And even rarer than that? Two rainbow babies in a single pregnancy. When Caitlin Hinson learned she was pregnant with twins, she was ecstatic. After losing two infants the year before, her prayers for a baby were doubly answered. The pregnancy was considered high risk because of her history, coupled with the fact that she was having more than one baby. And her risk shot up at the start of her second trimester, when an ultrasound revealed twin-twin transfusion syndrome, a pregnancy condition affecting identical twins. “She was devastated, but she was also very calm and showed a lot of courage,” recalls Kelecia Brown, MD, Caitlin’s OB/GYN at CMC Women’s Institute - Concord. “It was almost as if she anticipated some bad news.” Twin-to-twin transfusion syndrome, or TTTS, is a complication in which nutrients and blood flow from the placenta are shared unequally between identical twins. One baby might not get what it needs to grow, while the other is overloaded, which can lead to heart failure. Since they share a placenta and are connected by its blood vessels, the twins depend on each other to survive – their fates are ultimately tied together. Without surgery, the chance of losing one or both babies to TTTS is 80 to 100 percent. A laser procedure used to treat the condition is still risky, but it raises the chance of the fetuses surviving to 90 percent. After the diagnosis, Dr. Brown arranged for Caitlin to see Courtney D. Stephenson, DO, a fetal surgeon at CMC Women’s Institute’s Charlotte Fetal Care Center. Both doctors had cared for Caitlin in her previous pregnancies, so the mom-to-be trusted she was in good hands, with doctors who really knew her. Caitlin saw Dr. Stephenson regularly over the next few weeks, until she met the criteria to undergo the surgery for TTTS. The TTTS procedure involves a small camera placed inside the uterus to view the placenta surface and its vessels close-up. A microscopic laser then ablates, or destroys, the abnormal blood vessel connections causing the complication. It’s tedious, and for Caitlin, it was successful. Before the surgery, the babies were experiencing organ failures and severe complications – after the surgery, each twin’s problems were corrected, and they began developing at a healthy rate.

Keeping promises

With one obstacle out of the way, Caitlin should’ve been enjoying the final stretch of her pregnancy. Unfortunately, at the start of her third trimester, another ultrasound revealed more bad news: Caitlin had vasa previa, another potentially fatal pregnancy condition affecting the placenta and umbilical cord. Vasa previa is a rare complication in itself – and to have both TTTS and vasa previa in one pregnancy? Well, that’s practically unheard of. “That was the last thing in the world you could ever imagine would happen, especially after what she’d already been through,” says Dr. Stephenson.

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For Caitlin’s twins, a natural delivery was dangerous in itself, as the thing that brings them to life could also be what takes it away. Dr. Stephenson and the fetal care team watched Caitlin closely, avoiding labor as long as possible so the twins could continue developing. But after one successful attempt at stopping an early birth, Caitlin went into labor again at 30 weeks. “I told Dr. Stephenson that if my body was going to go into labor naturally, we needed to go ahead with it,” says Caitlin. Dr. Stephenson agreed. “I promised her, like I do all my patients, that I would do everything in my human power to save her babies. And that we would stop at nothing to get them here alive and well,” says Dr. Stephenson. A couple of hours later, after a careful C-section and delivery, there wasn’t a dry eye in the room, as two sweet little girls entered the world crying and bursting with life.

A miracle, times two

Iris Emilia and Isla Cora were born weeks early – and not without a couple of complications along the way. But they’re here now, and to all who love them, that’s what matters most. “I feel relieved and lighter now that the girls are here,” says Caitlin. Caitlin is forever grateful for her fetal care team – and for Dr. Stephenson, who she says saved her daughters’ lives twice. In fact, she even named one of her little girls after their lifesaving surgeon – Cora is a variation of Courtney, Dr. Stephenson’s first name. “They wouldn’t be here without her,” Caitlin adds. And for Dr. Stephenson, the feeling is mutual. “The mothers are the real heroes here. They place themselves on the operating table when they’re in perfect health, in total love and faith, for the hope of saving their unborn babies’ lives,” she says. “It’s an amazing thing that these women do.” Caitlin’s twin girls are getting stronger every day. They were recently moved from the neonatal intensive care unit to the neonatal progressive care unit at Levine Children’s Hospital. And soon, these rainbow babies will be free to go home, to live their lives with flying colors.

atriumhealth.org - Twin Rainbow Babies Beat the Odds – Twice - Atrium Health

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