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prenatal surgery
Delighted to be expecting her first child with her design engineer husband Peter, 35, Laura Etherington, 37, an account manager, was shocked but thrilled when, at her 12-week scan, medics announced she was having twins.
But the couple's world was turned upside down a month later, when a further scan detected a discrepancy in the size of their boys Stanley and Arthur – leading to a diagnosis of twin to twin transfusion syndrome (TTTS), an imbalance in the blood flow between twins while they are in the womb.
Warned that Stanley, the smaller boy, was not receiving any nutrients from the placenta they were sharing, so would not survive if doctors did not act fast, Laura, of Stamford, Lincolnshire, had no choice but to have laser surgery at 21 weeks, during which a huge two litres of amniotic fluid was drained from her womb.
Further devastating news came when a scan following the procedure showed that Stanley had sustained a brain injury.
But the boys, who were delivered at Leicester General Hospital by caesarean section on 8 June 2018 – with Stanley weighing 2lb 15oz and Arthur weighing 3lb 13oz – have surpassed all expectations and, now 18 months old, are both thriving.
Laura said: “The TTTS diagnosis was absolutely devastating. We'd gone from the amazing surprise that we would be welcoming two little ones, to it all going wrong so early on.
“Even after the surgery, we were still living day by day, scan by scan. We barely allowed ourselves to plan ahead, or get excited.
“We didn't even want to buy baby things, just in case, as it felt like we were constantly on the cusp of the next bombshell. But against the odds, the twins are here and they are such special little boys."
Delighted to be pregnant for the first time, Laura's excitement doubled at her 12 week scan, when a sonographer confirmed that she was expecting twins and that, as they were sharing a placenta, they would be identical.
As an expectant mother of twins, she was monitored closely and given frequent scans – with one at 16 weeks sounding the first alarm bell.
“We were told that there was a discrepancy between the size of the twins," she recalled. “Right away, a little alarm bell went off. I turned to Peter and said, 'This isn't going to be as straightforward as we thought, is it?' We went away really trying not to worry, but couldn't help it."
Two weeks later, another scan at Peterborough City Hospital showed that, not only was Stanley much smaller than his brother, but he had also stuck to the wall of the womb.
Laura continued: “The doctor just kept saying, 'I'm so sorry.' I was lying there thinking I had lost both the boys. It was absolutely devastating."
A consultant made the official diagnosis of TTTS – which, according to the charity Twins Trust, is a rare but life-threatening condition that affects 10 to 15 per cent of identical twins sharing a placenta – before transferring Laura's care to a Leicester hospital which specialises in treating it the following day.
“The first thing they did when we got to Leicester was give me a scan," said Laura. “When they said they could still detect two heartbeats, relief flooded through me. I had been terrified the babies wouldn't survive the night."
Hospital doctors also said it was imperative for Laura to have a laser ablation – which involves making an incision and passing an endoscope into the uterus, then sealing off the blood vessels on the surface of the placenta to stop the blood exchanging between the twins – or she could lose both babies.
“There was no real choice," she said. “Stanley would have died without it and if that happened, the blood flow to Arthur could be affected, which would put him at risk, too."
So, in February 2018, at 21 weeks, Laura headed to Birmingham Women's Hospital, where a renowned expert performed the delicate procedure.
To make matters worse, on the day of her appointment, the mega storm dubbed the 'Beast from the East' struck, meaning the couple drove to the hospital in a car packed with shovels and food supplies, in case they were stranded in the snow.
Luckily, they made it, and Laura was taken into theatre and heavily sedated but conscious for the hour long operation.
“Beforehand, my bump had been huge. I was only just half way through but looked full term, where the amniotic fluid was building up so much," she said. “During the procedure, they drained away two litres and right away, my bump visibly shrank.
“I was instantly more comfortable, but the scariest moment was the scan to see if the babies had survived. Thankfully, two heartbeats were detected, and while the blood flow between them wasn't perfect, it was much, much better."
Two weeks later, Laura had an MRI scan – thought to be safe after three months of pregnancy, according to the NHS – to check whether the lack of blood supply had affected Stanley's brain.
We can really see a future now - but maybe a slightly chaotic one - and we are very proud of both of them.
Laura Etherington
“Sadly, the results were pretty grim. He had almost had a stroke in the womb, where he'd not been getting any of the blood supply," Laura explained.
“Doctors said he had sustained a brain injury. It was really heartbreaking."
Instead of enjoying the bloom of pregnancy, Laura woke up every morning filled with anxiety until she felt her babies move, but she made it to 34 weeks, when she had a planned c-section at Leicester General Hospital.
Miraculously, Stanley only required oxygen for a matter of minutes before he began breathing independently.
Meanwhile, Arthur remained on a CPAP breathing machine for a few more hours, before both boys were transferred by ambulance to Peterborough City Hospital, so they would be closer to home.
They stayed in hospital for three weeks, where they were tube fed and grew stronger every day until they were ready to come home.
“The hospital and their outreach support were amazing," said Laura. “We were reassured that we could ring up at any time, so we weren't just being thrust out into the world with these two new babies."
Now 18 months old, Arthur and Stanley have defied all expectations. Stanley is slightly smaller and they are slight for their age, but Laura has been told that is to be expected and the boys, who share a touching bond, will soon catch up.
Their proud mum said it is a case of “wait and see" to determine exactly how Stanley's brain injury will affect him day to day, but the youngster has regular physiotherapy to help build up his strength.
Laura said: “Stanley is developing a little slower than Arthur, but he has already far surpassed expectations and amazes us every day.
“The boys giggle together and babble away in their cots. It's very sweet.
“Arthur has started to walk, whereas Stanley can't just yet. But if he ever drops his dummy or toy, Arthur will go over to pick it up and give it back to him."
Even after the surgery, we were still living day by day, scan by scan. We barely allowed ourselves to plan ahead, or get excited.
Laura Etherington
Now, by speaking out, Laura wants to both raise awareness of TTTS and thank Twins Trust for their support in her hour of need.
She concluded: “My advice to other parents would be that, with every pregnancy, you have the right to go and get something checked out if you are worried. But, it's important to try and snatch some moments of normality too, or the worry can be all-consuming.
“Stanley and Arthur are such happy little boys. As hopeful and positive as you try to be, we were always half expecting that we could lose them, but now we are really looking forward to the future and being parents to these twins."
She concluded: “We can really see a future now – but maybe a slightly chaotic one – and we are very proud of both of them."
For information, visit www.twinstrust.org