Top Doctors 2010: Prenatal Surgery Saves Twin

About four and a half months into Jeana Cassellius’s pregnancy, she and her husband, Jeff, received surprising news: They were going to have twins. Three days later, they received news of a much less happy nature. Jeana started bleeding and had to be rushed to the doctor, who discovered that one of the twins was much larger than the other. The twins were soon diagnosed with Twin to Twin Transfusion Syndrome (TTTS), a disease in which one twin produces too much fluid while the other twin makes hardly any. About a third of twins are identical, and, of that third, about 15 percent develop TTTS.

Upon diagnosis, the couple was sent to Abbott Northwestern Hospital, where Dr. William Block gave them two choices: They could remove amniotic fluid from the placenta to help carry the pregnancy to term or they could try a new, still experimental surgery. “It was an easy decision for us,” says Jeff. Adds Jeana: “We wanted to know that we did everything we could instead of an easy fix.” With the surgery, there was a 75 to 90 percent chance one twin would make it and a 40 percent chance both would survive. Without any treatment, TTTS has a 95 percent mortality rate for both twins.

The couple was in good hands, since Block—along with Dr. Brad Feltis of Children’s Hospital in Minneapolis—was responsible for bringing this procedure to Minnesota, after completing a training in Belgium a year earlier. Before Block and Feltis’s training, patients often went to Seattle or Tampa for the surgery, which involves entering the uterus and “zapping” the vessels that are communicating in the placenta. However, not all patients who needed the procedure could safely travel to get it.

Jeana’s surgery in July 2008 went well, but she still had four months until she was due to give birth. The couple had weekly appointments to keep an eye on the twins. “Every week we just kept hearing, ‘They’re good!’ We just really tried to stay positive,” Jeana says. “Dr. Block really helped us keep a level head.”

Four months and countless doctor appointments later, Owen and Gavin arrived. The twins, delivered by Block, were at a healthy weight, required no follow-up care, and went home with their proud mom and dad three days later. “Things couldn’t have gone better,” says Block. As for raising the twins? “It’s not as hard as we thought,” admits Jeana.