January 30, 2023

Emergency prenatal fetal surgery at UW Health Fetal Diagnosis and Treatment Center saves twins’ lives

Carter and Shea Anderla Home Photos
The Anderla family: Parents Chad and Phoebe holding twin boys Shea and Carter, with big brothers Camden and Pierce.

Madison, Wis. – On Nov. 1, 2022, twin boys Shea and Carter Anderla were born happy and healthy to the delight of their parents Phoebe and Chad.

It was a joyful day that almost didn’t happen.

The Anderlas, who live in Menominee, Mich., were undergoing routine monitoring of their twins with their maternal-fetal medicine doctor in Green Bay in early August when they were referred to the UW Health Fetal Diagnosis and Treatment Center at UnityPoint Health – Meriter Center for Perinatal Care in Madison for additional testing.

But what started out as a routine second opinion on a potential condition the twins were displaying turned into emergency surgery to save the babies.

Dr. Inna Lobeck, pediatric and fetal surgeon, and director of the UW Health Fetal Diagnosis and Treatment Center, and Dr. Michael Beninati, maternal-fetal medicine physician, UW Health, diagnosed the twins with Stage 3 Twin Anemia Polycythemia Sequence, commonly called TAPS, a rare condition where there are unequal blood counts between unborn twins, resulting in one baby giving blood and nutrients to the other, and becoming anemic, while the other baby receives too much blood and nutrients, causing their heart to work much harder.

If not treated, TAPS can be fatal for both twins, according to Lobeck, who is also an assistant professor of surgery at the University of Wisconsin School of Medicine and Public Health.

“Time was of the essence,” she said. “Phoebe was 23 weeks pregnant, and due to the seriousness of the condition, we needed to get her into surgery immediately, otherwise the twins might not have made it.”

The team operated on Phoebe and the twins within three hours of the family arriving at the center using a technique called fetoscopic laser ablation, where a fetal surgeon uses a tiny camera to see into the uterus, identifies the connecting blood vessels on the placenta causing the problem and uses a laser to close the connections between the babies. This surgery is typically performed between 16 and 26 weeks of pregnancy, according to Lobeck.

“I’ve never been more scared,” Phoebe said. “I had more than just myself to think about, the twins, my husband and my other children would all be impacted by our decision to move forward or not with the procedure, but we immediately connected with the care team and trusted them to save our babies.”

The surgery was successful, and the twin’s blood flow began normalizing almost immediately, Lobeck said. This was the first laser procedure performed at the center and the first set of twins born after visiting the center.

The family stayed at UnityPoint Health – Meriter Hospital in Madison for one night and then was able to return home for the rest of their pregnancy. The twins were born in Green Bay and had a brief stay in the neonatal intensive care unit before going home to join brothers Pierce, 7, and Camden, 2.

Phoebe and Chad are grateful to Lobeck and the entire care team for their bustling home of now four young boys.

“This feels like a miracle,” Phoebe said. “Our babies needed help and a center just a few hours away had recently opened that was able to save them.”

The UW Health Fetal Diagnosis and Treatment Center is a collaboration between UW Health and UnityPoint Health – Meriter to help support pregnant patients and their unborn babies who have birth defects before, during and after birth .

The center started seeing patients in March 2022 and includes a team of pediatric and fetal specialists, high-risk obstetricians and genetic counselors who evaluate, diagnose and perform fetal intervention when warranted, plus delivery and care after birth. The center also includes social workers and coordinators who support families’ needs throughout their care journey and beyond.

“Thirty years ago, these conditions were untreatable, often resulting in pregnancy loss, now we can intervene and change that,” Lobeck said. “The center is on the cutting edge of fetal therapy, and we are just getting started.”

The center manages a broad range of conditions, including congenital heart defects, urinary tract defects, spinal cord defects, head and neck masses, gastrointestinal and lung defects, as well as complex twin conditions, such as TAPS like the Anderla family experienced, according to Lobeck.

“The center for perinatal care has been providing excellent care to high-risk pregnant patients and those with fetal concerns for the past 20 years,” said Sherry Casali, chief nursing executive and vice president of patient care at UnityPoint Health – Meriter.

“Now patients can access an even broader range of fetal treatment here in Wisconsin, we are tremendously excited to support this growth and innovation in fetal diagnostics and treatment,” she said.

The Aderlas’ story is an example of how the center offers families hope, according to Lobeck.

“We are so excited to offer this resource for families in Wisconsin and beyond,” she said.

Watch the Anderla family's story