At only 9 weeks gestation, we discovered that Angelo had a large cystic hygroma.  The doctors suggested genetic testing as they were confident that the hygroma was a marker of a genetic abnormality.  We later learned that neither Angelo nor Asher had any genetic abnormalities. 

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At 12 weeks gestation, Angelo and Asher survived a threatened miscarriage after massive bleeding for days.  The cause of the bleeding was unknown.  At 14 weeks gestation, the doctors asked us if we wanted to terminate the pregnancy as they were confident the twins would not survive pregnancy much longer.  At 16 weeks gestation, Angelo was diagnosed with a rare congenital heart disease, Hypoplastic Left Heart Syndrome (“HLHS”).  The doctors warned us that HLHS is incurable, but there are three open heart procedures that they can perform to hopefully compensate for the non-functional left side of the heart.  Angelo’s prognosis was also further complicated by the fact he was a twin sharing a placenta with Asher, meaning that they would undoubtedly be born prematurely.

 

At 19 weeks gestation, Angelo and Asher started to develop Twin-to-Twin Transfusion Syndrome (“TTTS”), wherein Angelo was transfusing his blood to Asher in an unequal amount, necessitating surgery on the placenta to sever their connected blood vessels.  We almost lost the twins again at 20 weeks due to pre-term labor and my cervix began to dilate.  Thankfully, and miraculously, the labor stopped on its own.  At 22 weeks gestation, Angelo and Asher survived emergency fetal laser ablation surgery to correct the TTTS progression.  This meant that the babies would likely be born within 8 to 10 weeks from that point.

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For the following 10 weeks, Angelo held on as best as he could.  Angelo was much smaller than Asher due to intrauterine growth restriction that he developed after surgery.  Angelo’s umbilical cord was also missing a vessel, and since he only shared 30% of the placenta after surgery, he was fighting to grow proportionally with Asher.   At 32 weeks, Angelo decided to start moving down the birth canal to meet us.  We could not hold them in any longer.  After only four pushes, Angelo was born weighing 2 lbs 8 oz and was 16.9 inches long.  Asher was born weighing 3 lbs 15 oz and was 17.3 inches long, to compare their size difference.

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The two days that Angelo lived on earth were chaotic.  The twins were born at Prentice Women’s Hospital on a Wednesday night.  A few hours later Angelo was separated from Asher and transferred across the street to the Cardiac Intensive Care Unit at Lurie Children’s Hospital.  By Thursday afternoon, Angelo’s care team noticed that his heart was pumping too much blood to his lungs, meaning that he would need heart surgery sooner than was ideal. On Friday morning, Angelo underwent a catheterization procedure to place flow restrictors in his heart to stabilize the blood flow.  By Friday afternoon, Angelo’s body began to reject the flow reducers so his heart and subsequently all other organs began to fail.  Angelo passed away in my arms at 7:52 p.m. that evening.

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Although we would have done anything necessary to care for Angelo’s heart disease as long as he lived, it is comforting knowing that he is at eternal peace.  He also does not have to undergo three open heart surgeries before the age of 3.  We thank God that He was kind enough to allow us to witness Angelo’s first breath on earth and hold him during his last breath.  We would make the decision to carry him all over again.  Despite how painfully short his life was, I am thankful that we met him alive.  Now it is time for Angelo to live on in our hearts and in Angelo’s Prenatal Club until we meet him again.