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OHSU fetal surgeons save twins facing life-threatening condition

Family shares the journey to welcome twins with the help of OHSU Doernbecher’s new fetal surgeons who perform complex, in-utero surgeries
Left to right: Caucasian male in backwards baseball cap holds a newborn twin baby; Asian male holds second newborn twin baby; adult female stands next to them.
Andrew Chon, M.D., pays a visit to the Hungate twins after delivery. With Dr. Chons special training, OHSU Doernbecher is able to perform complex, in-utero fetal surgeries that help families like the Hungates. (Courtesy of the Hungate family)

After struggling for years to conceive and undergoing various fertility treatments, early this year Chelsea Hungate was overjoyed to discover she was pregnant, and better yet, expecting twins. She and her husband were excitedly preparing to welcome home their two babies in the fall — busy picking out names, transforming their guest room into a nursery and preparing for their new role as parents.

In June, Hungate arrived to her 30-week ultrasound appointment at a hospital in Beaverton. Throughout the pregnancy, she’d visited that hospital for ultrasound appointments every three weeks, so at first this felt like an ordinary visit. But soon into her appointment, Hungate noticed a palpable shift in the provider’s demeanor.

“I remember the sonographer just stopped talking,” she said. “Then they started taking new ultrasound measurements which I’d never seen them take before, so I was concerned.”

The physician suspected a condition in one of the twins known as hydrops, which is when large amounts of fluid buildup in a baby’s tissues and organs. Hydrops is life-threatening to a developing baby and must be treated quickly.

Smiling Asian man wearing glasses.
Andrew Chon, M.D. (OHSU)

Chelsea was immediately sent to Oregon Health & Science University’s Doernbecher Children’s Hospital to receive care from specialized fetal surgeons, Andrew Chon, M.D., and Raphael Sun, M.D. OHSU already offered the most complex fetal care in the state, and with the recent addition of surgeons Chon and Sun, the program can now provide in-utero — or inside the uterus — treatments for nearly a dozen complex conditions that occur during pregnancy, including hydrops. OHSU’s program, directed by Stephanie Dukhovny, M.D., is one of only five programs nationally to provide medical and surgical interventions for high-risk pregnancies and newborns all under one roof.

Smiling adult man wearing a necktie and suit.
Raphael Sun, M.D. (OHSU)

Chelsea’s husband, Billy, noted that as they arrived at OHSU, they didn’t yet comprehend the urgency and seriousness of the situation. “I remember arriving and taking pictures of the view of Mt. Hood and thinking how beautiful it was up there,” he said. “We definitely weren’t ready for what was about to happen.”

Chelsea was admitted upon arrival, and the OHSU fetal care team immediately began to assess the babies. The team explained how serious the condition was and began to develop the best course of action.

Adult caucasian female with chin-length hair smiles
Stephanie Dukhovny, M.D. (OHSU)

“The doctors told us that if we didn’t do something, our baby wouldn’t make it through the weekend,” she said. “It was horrible. I was so shocked because I was so far along and my pregnancy had been smooth up until then. I just thought, there has to be another way.”

In many such cases, physicians consider selective reduction of the affected twin — or reducing the number of fetuses in the uterus — in an attempt to optimize the outcome of the other twin. However, with their special expertise in fetal surgery, Drs. Chon and Sun offered another option: They could perform an in-utero surgery to place a shunt in the fetus’s chest, which would allow the excess lung fluid to drain out. The surgery is complex and risky, and many providers aren’t able to perform it on twins. But because OHSU’s fetal care team is specially trained for complex cases such as the Hungates’, they were able to quickly intervene.

The team was working against the clock. Chelsea was given steroid shots and prepared to go into surgery the next day. Although the situation was scary and overwhelming, she felt good with the plan and the support of the OHSU fetal care team — who were confident in their recommendations, but, she said, also allowed her the autonomy to voice concerns and make decisions.

Over the next several days, Chelsea underwent two surgeries to ensure the shunt was correctly inserted and stayed in place. After the second procedure, the team breathed a collective sigh of relief to see that the approach was working — the baby’s fluids were draining to normal levels. The family now had a very good chance of bringing home two healthy babies.

Chelsea went on to deliver her twins — who are now healthy and happy at home — giving them the names Adalee and Ayla, meaning “bearer of light” and “coming from a strong place.” Her parents say the name is a tribute to the strength and resilience shown throughout the pregnancy journey.

Chelsea notes the impact the fetal care team had on her pregnancy and birth experience, recalling how both Chon and Sun paid a visit to her hospital room to meet the babies and offer congratulations between their surgeries.

“They were so kind and comforting throughout the process, which made an incredibly hard situation easier,” she said. “We know these doctors are busy saving lives all of the time, but they still managed to make us feel so safe and special, like we were the only patients they had. They cared so much for us and showed us they were willing to go above and beyond for our babies. We’ll be forever grateful.”

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