A young mom has told of her pride at her miracle identical twins, who were given just a 5% chance of survival before being saved by a laser operation in the womb.
When Harriet Alderman, 21, discovered she was expecting Hugo and Hayze Zani, she was beside herself with excitement – only for a scan at 22 weeks to deliver a crushing blow.
Spotting a significant amniotic fluid imbalance between the boys, doctors diagnosed them with twin to twin transfusion syndrome (TTTS), which occurs when the blood flow between unborn babies is unequal.
They then broke the news to Harriet and her partner Jeffrey Zani, 20, who are both criminology students, that, unless they acted fast, their sons would have just a 5 to 10% chance of survival.
Their only option was a laser ablation – a 45-minute procedure 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.
But, medics warned that, even with the operation, in their case the twins had just a 30% chance of both surviving, and were also at risk of being brain damaged.
Against the odds, the miracle tots pulled through, and, discharged from hospital after 10 days, are now happy seven-week-olds, who love sharing cuddles with each other.
Harriet, of Cardiff, south Wales, said: “After the boys were born, we were thinking something was going to go wrong – but every day, they were getting stronger.
“At first, Hayze was in an incubator, but then they put him in the cot with his brother – and after that, he didn't need to go back into the incubator."
Harriet said: “Hugo helped Hayze get stronger. They had an instant bond. They started to hold hands. Now they sleep in the same cot, in the same pushchair and carry cot. They suck each other's noses and face each other like they are kissing."
Harriet explained that her first pregnancy was textbook, with her finding out she was expecting twins in December.
Then, everything changed after her 22 week scan at Oxford's John Radcliffe Hospital near where her partner lives.
After spotting a fluid imbalance between the babies, doctors officially diagnosed TTTS.
According to the charity Twins and Multiple Births Association (TAMBA), the condition only affects identical twins who share a placenta and the statistics are grave, with 90% of babies likely to die if left untreated.
Ordinarily in twin pregnancies, the blood vessels within and on the surface of the shared placenta connecting both babies should allow blood to flow evenly between them.
But, in TTTS, the flow is uneven, and the resulting lack of blood supply will affect the growth of one twin, known as the donor, while the recipient twin has a higher blood volume, which can put a strain on their heart and lead to them producing excess amniotic fluid via urination to compensate for the excess blood.
Harriet recalled: “At 20 weeks, the scan was fine – but just two weeks later, there was a different atmosphere in the room.
“I knew about TTTS already, because I knew someone who had it and had the worst outcome. Their twins did not survive, so I automatically expected the worst. I was hysterically crying."
Harriet continued: “Doctors told me the TTTS was stage three, which meant it was starting to affect Hayze's heart function. He was the recipient twin so was in a lot of fluid. Hugo, the donor twin, was not getting enough nutrients."
Referred to central London's University College Hospital, which was the nearest hospital that did the procedure, Harriet was told if she didn't opt for the laser ablation surgery, there was just a 5 to 10% chance both twins would survive.
But heartbreakingly, even with the surgery, the odds were still stacked against Harriet and the boys.
She continued: “They told me that in our particular case there was a one in three chance of them both surviving the procedure.
“It felt like a low percentage, but I knew I had to go with through with it."
So, in May, at 22 weeks pregnant, Harriet had the laser ablation under local anesthetic – meaning she was awake the entire time as the surgeon cut through her stomach to reach her womb.
She added: “When it went into the womb, I felt the worst pain I'd felt in my life. I imagine it feels like being stabbed.
“When he was inside, I could see the babies on the screen. I could see their little feet and toenails, and was so upset because I thought, 'They have no idea what is happening and what they are going through.'
“I was crying so much that my stomach was moving up and down. They told me I needed to stay still so I just closed my eyes and tried to stay calm."
During the procedure, doctors also drained two liters of amniotic fluid to relieve the pressure on Hayze.
Harriet and Jeffrey then faced a nervous wait in the recovery room before she was scanned two hours later to see if the twins were still alive.
Harriet continued: “There were two heartbeats, but I was warned that things could still go wrong. The twins could go into shock and die."
She added: “Doctors said, 'If they are still alive after two weeks, there's a good chance they will make it through the pregnancy.'
“Every day, I was so nervous and emotional. I was poking my belly to try and get them to move. It was the worst two weeks of my life.
“People would try and make me feel better by saying things like, 'If you have one surviving twin you should be grateful,' but I love them both equally. Both are my children."
“I already had their names and knew which was going to be which. I needed them both to be okay," Harriet continued.
“Two weeks later, when I went for my scan, my family came with me and they were all in tears. It had an impact on everybody."
At 30 weeks, Harriet had an MRI scan, which are thought to be safe in later pregnancy, according to the NHS, to assess whether there were signs of brain damage in the babies – which thankfully, there was not.
But rather than feel relieved, she remained anxious throughout the rest of the pregnancy.
She explained: “The happiness of being pregnant had been taken away. I was doing all I could to make them stronger, eating lots of protein and making sure I rested."
Then, at 33 weeks, a scan showed signs that the TTTS was returning, and Hayze had began to suffocate as the fluid around him was reducing.
So, medics decided to book Harriet in for an emergency caesarean section four days later.
The twins were finally born on July 23 at Swansea's Singleton Hospital, with Hugo coming first, weighing 4lb 14oz, followed by Hayze three minutes later, weighing 3lb 9oz.
“Hugo was screaming, and I remember thinking 'Oh my gosh, he's breathing.' I was crying my eyes out. It was the happiest noise I had ever heard," Harriet said.
“Then Hayze came, and he was screaming too. I thought it was a miracle," Harriet recalled.
“There were about 30 people in the room. They were on standby, but after checking the twins, they plonked them on my chest. I got to hold them straight away."
While Hugo was allowed to stay with his mom, Hayze was taken to intensive care as he was having difficulty breathing properly.
Neither twin was able to suck or swallow at first because they were so little and so required feeding tubes.
But slowly, they began to rally. Hugo started to develop his a couple of hours after birth, but still needed help with the tube, and Hayze did after 10 days. After a week they were both feeding but were monitored.
Harriet said: “Nobody could believe how well they were doing. With Hugo, they had never had a baby that small on the ward who did not need the incubator."
She added: “People said I would be looking at three months in intensive care with both babies, but Hugo was not in intensive care at all and Hayze was only there for three days before he was allowed back up to the maternity ward."
After 10 days, the couple were allowed to bring their little miracles home.
“They were so tiny, they couldn't even fit into the car seats. I had to hold their heads as we drove home."
Harriet added: “Hayze's leg was the same size as my little finger. He looked like a little bird."
Now, though Harriet and Jeffrey must be careful not to expose the boys to any infections as their immune systems are still weakened, they could not be prouder of how well they have done.
The only lasting side-effect of the TTTS that they know of at the moment is a small hole Hayze has in his heart.
“There are certain things he won't be able to do like go deep sea diving or some extreme sports but it shouldn't really affect him," said Harriet.
“It was amazing having them home. At first, I couldn't sleep because I was just staring at them.
“With all that's happened, I was thinking, 'How have I got here?'"
“Hayze is now 5lb, and Hugo is 7lb and I can't believe how alert they are. They are gorgeous," Harriet explained.
“I never thought I would have them. It's amazing and we are so grateful. Everyone is so happy that they are here."
Harriet has set up an Instagram page to track the boy's progress and share their story: @zani_twins
