Monday, May 3, 2010

Update on Mishael

This is Maria, I'm posting the latest on Mishael's triplets! I am in Seattle with Nancy (Mishael's Mother-in-law) and Mishael and Eliza. After wandering around a huge hospital trying to figure out where we were supposed to be we sat in a 4 hour long ultrasound appointment. The US tech was very knowledgeable and happy to show us what she was looking at and explain what things meant. Everyone that came in to talk to MIshael knew all about her case and had reviewed her charts etc. and seemed to know what they were talking about.
First, the US tech did a brief overview of all the babies to see where they were and make sure they had heartbeats. They all had good heartbeats above 130. Then she told us they are all girls!! Yay! Then she went back and spent about 45 min a piece on each baby, measuring specifics parts of the babies. She measured all their little blood vessels and arteries and got different views of their hearts and even measured specific bones.
Then the Dr came in and discussed the results and explained everything and answered questions. This is what we learned:

They are definitely identical triplets with one placenta. They have 3 vessel cords (which is better than 2). Two of them have Stage 3 Twin to Twin transfusion syndrome.

Baby A is the recipient and is getting more fluid (blood etc) than she should from baby C. Because of this, her body is in fluid overload and her little heart cannot handle all of the extra fluid. She is very active because she has so much fluid to move around in so she is hard to measure because she is constantly moving. Because of this, they couldn't' get all the views of her heart that they wanted to but they could tell the heart function was compromised. They are actually more worried about baby A than baby C because of the fluid overload. They also said there is a possibility baby A has a heart defect but will not be able to tell until the baby is bigger and they can do an echocardiogram and see more views of the heart. This would be a separate issue than Twin-to-Twin transfusion syndrome but the extra fluid would make it even harder for the baby's heart to function right in addition to a heart defect. Baby A measures with way too much fluid but as far as growth goes is 18 wks 5 days.
Baby B measures 18 wks 2 days and everything looks ok but her fluid is on the low end of normal so there's a possibility there's some transfusion going on there too. They will check the vessels during surgery and fix them if there is some shared vessels between baby B too so they wouldn't have to repeat the surgery later with baby B.

Baby C measures 17 wks, so not too far behind! However her fluid is way too low and she is very dehydrated and has nothing in her bladder and is showing signs of dehydration with the tests. However her bladder is still visible and her Heart seems to be functioning properly at this point.

As a result of these tests, the surgery will occur tomorrow morning. The procedure is done under spinal anesthesia and Mishael will be awake the whole time and can watch the whole procedure on the monitor. They will also put the surgery on a DVD and she can take it home and watch it afterwards! Cool huh? They will keep her in the hospital overnight to monitor for any bleeding or premature labor and then she will have a follow-up appointment on Wed morning and she can go home wed if everything looks good. The next two weeks will be the crucial time to see if the babies will do well with the procedure.

The Dr said the chances of losing the babies is 90% if she doesn't do surgery and the risk of losing the babies because of the invasive surgery is 10%. So the risk is worth it at this point. The Dr said she has only seen a few identical triplets before but surprisingly just did this same surgery on another set of identical triplets on Friday...So far so good, with those ones...

That's about all I can think of right now. I'll keep you updated after surgery tomorrow.



  1. I will be praying tomorrow regarding the surgery, the babies and the mother. This is too close to home... just 4 hours from me. You will be on my mind much tomorrow too. Please let us know how things progress. Take care.

  2. I'm praying that the surgery goes well.

  3. I am praying too. I have triplets and 2 had TTTS, though we didn't need the surgery. I will check back for the update! Praying!

  4. Hi again, if you haven't seen this already it's the TTTS foundation. They were priceless to me...

  5. Wow wow wow!! We're praying for Misheal and her little girls!!