Doctors perform rare procedure, parents and babies demonstrate strength
Lindalva Pinheiro DaSilva is resilient. And so are her twin boys.
But they’re not your typical twins; Alexandre and Ronaldo were born 24 days apart.
After being pregnant for just 24 weeks, DaSilva’s amniotic sac around baby Alexandre broke on February 26, 2014, three and a half months before her scheduled delivery date, June 18. DaSilva was transferred to Tufts Medical Center from Cambridge Health Alliance because of Tufts MC’s expertise in high-risk pregnancies and deliveries.
Thanks to the work of highly skilled doctors in the Maternal-Fetal Medicine and Neonatal Intensive Care Unit (NICU) units, Alexandre’s birth was postponed by four days. DaSilva was given antibiotics, plus medicines that calm contractions, protect a baby’s brain and help a baby’s lungs mature. Alexandre was born at 24 weeks, five days on March 2, 2014, weighing 1 lb., 10 oz., and was immediately placed in Tufts MC’s Neonatal Intensive Care Unit. According to Sabrina Craigo, MD, Chief of Maternal-Fetal Medicine at Tufts MC, babies born that early have around a 50 percent survival rate. As a result, when the second baby turned back from the birth canal, Dr. Craigo made the decision to delay the second twin’s delivery for as long as possible to allow the baby to further develop and grow in the womb and increase the chances of his survival.
Delayed Interval Delivery
How was this possible? To attempt delayed interval delivery, Dr. Craigo had to act within a brief window of opportunity in which DaSilva’s labor slowed after the birth of Alexandre; there was no sign of infection or heavy bleeding and the amniotic sac of the second baby, Ronaldo, didn’t break. This rare technique can only be performed with fraternal twins who have their own amniotic sac and don’t share a placenta. Additionally, it’s vital that the mother’s contractions subside following the birth of the first baby for delayed interval delivery to be successful. "I've seen two others in my career thus far, I think the longest interval between deliveries has been seven days at most,” Neonatalologist Gina Geis, MD said in an interview with WHDH-7.
More than three weeks later, Ronaldo was born at 28 weeks, 1 day on March 26, 2014, weighing 3 lbs., 3 oz. He did not need a high-frequency ventilator, which Alexandre had required for the first several weeks of his life due to respiratory problems.
Both babies are doing exceptionally well, which is exceedingly rare in the case of delayed interval deliveries; Half of all infants born at 24 weeks don’t survive, and those that do are at risk for complications. It’s even less common to have nearly a month in between births; typically, there are only a few days between births. Errol Norwitz, MD, PhD, Chairman of the Department of Obstetrics and Gynecology at Tufts Medical Center, said this was only the third case of a delayed interval birth he had seen in 25 years of practicing medicine – and in the previous two instances, the first baby did not survive. Dr. Craigo also had never seen a case quite like this in her career.
One June 27, 2014, the day the babies were discharged, the father of the twins, Ronaldo Antunes, made the moment extra special by asking DaSilva to marry him - and the twins were involved in the proposal. One of their outfits said, “Mom will you…” and the other, “Marry Dad?” Of course, she said, “yes!”
The family’s story has garnered attention both locally and nationally with coverage on Good Morning America, The Tonight Show and The Boston Globe, among others. The Boston Globe called it “…One of the most successful delayed twin deliveries Boston doctors can recall…”