'We got a phone call at home to say she’d taken a turn for the worse' - Identical twins now thriving after being born premature at 26 weeks

Nicole and Joe welcomed identical twins Ava and Amelie, who were born premature at just 26 weeks at Birmingham Women’s Hospital, and were cared for on the Neonatal Intensive Care Unit (NICU) for over 11 weeks before they were well enough to go home.

Nicole, who was living in Lichfield at the time, was seen at the hospital's Fetal Medicine Department when they noticed at her 16-week scan one of the twins was growing significantly smaller than the other.

The Fetal Medicine department discovered the twins had Selective Intrauterine Growth Restriction (sIUGR), a condition that can occur in identical twin pregnancies where one twin is growth restricted due to an absent or reversed flow from the umbilical cord.

Recounting her experience which began more than two years ago, Nicole said: “It was my first pregnancy, and we found out we were having twins six weeks in and the pregnancy was going smoothly.

“They noticed at a scan one of the twins was growing significantly smaller, so we were referred to the Fetal Medicine team.

“We’d never heard of the condition before, and it was really scary knowing something was potentially wrong.

"It was all due to where they’d ended up connecting to the placenta. The bigger twin was plugged in at a larger part so was getting plenty of nutrition, but the smaller twin was plugged into the tail end of the placenta, meaning she wasn’t getting enough nutrition and was so much smaller.

“We didn’t know what this would mean for them, but everyone was so kind and reassuring and explained things in a way we could understand.”

Nicole was scanned twice a week to closely monitor the smaller twin's growth, until Nicole was 26 weeks pregnant and was admitted overnight for daily monitoring.

She said: “Her heart rate kept dropping low on the monitor, and we were starting to get concerned and thinking about having to deliver them early.

“It kept dropping and taking longer to come back up, and one of the consultants who looked after us said that it was time for them to come out now.”

Ava and Amelie arrived prematurely at 26 weeks and 4 days, weighing just 2.2 and 1.9 pounds.

 Nicole said: “I was able to see both girls after they were born before they went straight down to the NICU, where they were both intubated for 24 hours before progressing onto oxygen. Joe went down with them, and once I’d recovered, they took me to see them, and they looked so tiny and fragile. 

“Amelie, the smaller twin, kept getting blood in her feeding tube, so had to be nil by mouth due to the risk of infection. She had a much harder ride to start with, but she kept fighting.”

Both twins started to get stronger with the help of oxygen and feeding tubes, however, when Ava was six weeks old she developed Necrotising Enterocolitis (NEC) which, an infection which can affect premature babies and is a condition where the bowel becomes inflamed and damaged.

Nicole recalled: “Something hadn’t been quite right with her tummy the day before, but then we got a phone call at home to say she’d taken a turn for the worse.

“It was horrible hearing the phone ring in the middle of the night knowing it was probably about the girls, but knowing we weren’t with them. They were both so strong and were real fighters all the way throughout.”

During their stay at the NICU, Nicole and Joe visited every day, arriving first thing in the morning and staying until last thing at night. They also received counselling on the unit and were part of the family group that had been set up for parents to share their journey.

Nicole said: “Nothing can prepare you for a stay on the NICU. While we were there, we lived in our own little bubble and we didn’t talk to family or friends much because it was hard to explain how it feels, and you don’t know what’s going to happen next.

“The team were really supportive, and they helped us be as hands-on as possible with their care, and the family group was really helpful too. It was nice to be able to talk to other parents who knew how it felt and were going through the exact same thing too. 

“Walking away from your babies every night was just horrible, so to finally leave with them was a huge relief.

“When we went home, they both still had a feeding tube, but the team were brilliant in giving us training so we could do it ourselves at home.  Both tubes ended up being removed the next day as they were doing so well breastfeeding.”

The twins are now over two years old and are thriving at home after their difficult start to life.

Nicole added: “They’ve got such different personalities now, but they’re both very cheeky little girls. Ava especially loves animals and trips to the farm, and they both love singing and dancing around the house. They both absolutely adore their younger sister and they’re so gentle and kind with her.

“We’re so thankful for everyone at the Women’s Hospital for looking after our girls, they’re both so strong and such fighters and we couldn’t be prouder of how far they’ve come already.”