Twins, but born three weeks apart

Think twins are always born minutes apart? Not in every case! A California woman gave birth to two boys three weeks apart. According to medical literature of the last 40 years, it is the second longest interval between twin deliveries where both babies survived, and may be the only case in which both babies were delivered in good condition."Even though we're an institution that routinely manages high-risk pregnancies, we were initially stunned by this case," said Dr. Manuel Porto, director of the Division of Maternal-Fetal Medicine and the Center for Fetal Evaluation, part of the University of California, Irvine (UCI) Medical Center in Orange, California. "But we knew we had the resources to give these babies a good chance of survival."

Lori Abbott, 35, of Coto de Caza, was admitted to UCI Medical Center on March 1998 in her twenty-fourth week of pregnancy when she went into labor. "At that stage in pregnancy, babies are in a very precarious state if they are born prematurely," said Dr. Feizal Waffarn, chief of Neonatal-Perinatal Medicine. Abbott was placed on medication to halt her labor, but after 10 days her cervix had dilated nearly half the amount needed for birth to proceed, and the legs of one of the twins had already descended into the birth canal.

Abbott was advised that the doctors would attempt to deliver the first twin and see if the second twin could be kept in the uterus as close to term as possible to continue its development. "Fortunately, the twins are fraternal and developed with separate placentas and amniotic sacs," said Porto, "so delivering one twin did not mean that we had to automatically deliver the other."

Michael Jeffrey Abbott arrived on April 9, 1998 and weighed in at a mere 1.6 pounds. Dr. Jack Sills, medical director of the Neonatal Intensive Care Unit (NICU) and Special Care Nursery assisted in the birth and told Waffarn afterward, "I have to check in with another patient now, but call me when it's time for the other twin." The call, much to the surprise of Sills and the other doctors on the team, never came.

Abbott was placed on medication to halt her labor and put on strict bed rest, meaning virtually no movement out of bed whatsoever. As the pregnancy continued day by day, doctors watched in astonishment. Michael, though put on a respirator because his premature lungs were still developing, continued to show no complications resulting from his premature birth, and the doctors grew more confident that he would thrive.

"If the premature babies in our unit survive the first week, they have a greater than 90 percent chance of survival," said Sills.

Indeed, three weeks later, Sills, Waffarn and Porto got the call-Abbott was in labor. At 3:55 a.m. on April 30, Kenneth Roy Abbott was born, weighing in at 2 pounds, 2 ounces.

"Because we're a teaching hospital, we often talk about challenging theoretical cases, and coincidentally, not too long ago we pondered a case just like Mrs Abbott's," said Porto. "That it actually happened and turned out so well is something we are extremely pleased about."

Abbott and her husband Robert, 51, are looking forward to telling their twin boys the amazing circumstances surrounding their birth. Baby Kenneth went home on June 22, and Michael left the hospital a short time later.