Twins Survive After Developing Rare Condition in the Womb: 'They're Such Miracle Baby Fighters'
On August 10, over two months after they entered the world, twins Pauly and Vinny Salmonese were finally able to be together for the first time outside of the womb. It was a joyful, tear-filled day for parents Dana and Joe Salmonese, and a major milestone after a rollercoaster pregnancy that included an extremely rare syndrome, a hemorrhage and the stress of a global pandemic — but ended in baby joy.
Dana, 30, first learned that she was expecting twins just after New Year’s Day — “a shocker” for the couple, with no history of twins in their families. In the weeks that followed, everything was going smoothly, and Dana excitedly announced on Facebook at week 13 that they had two babies on the way, joining their now-20-month-old daughter Gianna.
But one day after her post, Dana suddenly woke up in the middle of the night gushing blood.
“I thought I had lost them. It was the scariest moment of my entire life,” she tells PEOPLE. “There was no doubt in my mind that I was miscarrying.”
Dana and Joe rushed to the hospital near their hometown of Huntington, New York, praying that the babies were okay. A sonogram thankfully showed two healthy heartbeats, but Dana had suffered a subchorionic hematoma, which the babies had just a 50-50 chance of surviving, and she needed to go on bedrest.
It was tough on Joe and Dana, who couldn’t pick up or play with Gianna, but by the time she hit 17 weeks pregnant she had stopped bleeding and would soon be able to move around again.
“I was excited to have a normal pregnancy from there on out, but it didn’t happen that way,” she says.
Instead, the doctors noticed an abnormality during the sonogram.
“I was looking at the monitor, and I’m noticing that one wasn't moving, one was looking like he didn't have much room at all, and he was still,” Dana says. “The other one was floating and he had all this room, and his arms were up and kicking all over and I couldn't feel any of it. And I thought that was kind of weird.”
Dana’s doctor said that it was likely twin-twin transfusion syndrome, a rare condition that occurs when twins are sharing a single placenta and one baby receives more blood flow and nutrients than the other. Her doctor immediately made Dana an appointment with Dr. Martin Chavez, a specialist in maternal-fetal medicine at NYU Winthrop Hospital.
“She was so adamant about it that she made the appointment herself. And that's when I was like, this must be really serious for a doctor to go out of her way to make sure that I get in, get in to see someone that same day. So I was really scared,” Dana says.
Chavez explained — in a “level-headed but compassionate” manner that Dana appreciated — that the babies had stage 2 twin-twin transfusion, and that he needed to perform a laser photocoagulation, a type of in-utero surgery, the next day.
“What was happening is that one was getting too much blood and one was not getting enough, so we use a laser to close these abnormal connections, allowing the pregnancy to continue as far along as possible, and as safely as possible,” Chavez tells PEOPLE.
If Dana didn’t undergo the surgery, the babies had just a 10 percent chance of survival.
“I knew I had to do it. There was no doubt in my mind,” she says. “It’s risky to go into the womb with 18-week-old babies, but it would be even more risky not to.”
The surgery, though, had complications — it was supposed to be just an hour or two, but when Chavez went into the womb, Dana’s amniotic fluid was murky, likely a complication from her subchorionic hematoma. He had to slowly drain all of the amniotic fluid and replenish it with saline so he could see inside the womb and correct the issue with a laser.
The next day, the twins’ fluid levels had evened out and the surgery appeared to be a success. But two weeks later, at 20 weeks pregnant, Dana’s water broke.
“It was a big gush, and I thought I lost them all over again,” she says. “I thought, ‘This is it, I’m delivering 20 week old babies.’ ”
At the hospital, Chavez saw that the babies had very little fluid, but Dana wasn’t having contractions and the babies were still okay in the womb, so he opted to wait. The only issue was that it was now March 26, and COVID-19 was nearing its overwhelming peak in New York. The maternity floor Dana was currently on was about to turn into a COVID-19 ward.
“He said, ‘I wish I could keep you here, but I can’t, I'm too scared that you would get COVID,’ ” Dana says.
So she again went home to more bedrest, while monitoring her temperature every hour to make sure she didn’t develop an infection that could put her life at risk.
“It was so stressful. And Joe is a first responder, so he was going on call as a firefighter and seeing COVID every day, transporting people that couldn’t breathe,” Dana says. “He would get home and take off all of his clothes, his boots, everything, after a shift, and fearing that he would bring it home to me. It was overwhelming for him.”
Dana knew she had to get to 24 weeks for a viable pregnancy, one that would give the twins a better chance of survival. Every week that passed was a celebration, and when she hit 24 weeks her friends and family organized a drive-by parade, complete with fire trucks from her husband’s station.
“I was so happy when I made it to 24 weeks. I knew I was giving birth to babies that wouldn’t have to die in my arms,” she says.
Dana managed to go another another four weeks, to 28 weeks pregnant, before her contractions started. By this point it was late May, and New York had a better handle on COVID-19, so Chavez decided to admit Dana to the hospital and see if the twins could stay in the womb for a few more weeks.
The next three weeks were stressful, but Dana stayed entertained by chatting with her roommate Jen, watching the Food Network, praying and counting down the hours until the snack cart man Howard stopped by with daily treats. During a checkup at 31 weeks, they noticed that the smaller twin was not getting anything from the placenta, and Dr. Chavez decided it was time to deliver.
“Even though I did not want to give birth at 31 weeks, it was like the light at the end of the tunnel,” Dana says. “And I was so happy that I had made it 11 more weeks after my water broke.”
Vinny (left) and Pauly Salmonese
During her C-section, Vinny arrived first, at 4 lbs., 1 oz. Next was Pauly, at 2 lbs., 9 oz., and both babies were immediately taken to the NICU to get intubated and put on oxygen.
“After everything they went through, they needed a lot of respiratory support, and they needed blood transfusions. But those doctors and nurses, they really know what they're doing. They are geniuses and they know how to push your babies without pushing them too hard,” she says.
And the babies thrived, quickly gaining weight and building up their lungs.
“They’re both doing exceptionally well,” Chavez says. “It’s typical for multiples to develop a kind of sibling rivalry to see who gets bigger, faster and who’s eating better, so it’s nice to see that kind of competition happening with the Salmonese twins.”
After their first outside-the-womb meeting on Aug. 10, Vinny was able to go home from the hospital, and Pauly will follow in the next few weeks. Dana is most excited for “the little things that you usually don’t think is a big deal, like the ability to just kiss them without a mask on,” she says.
Soon, the twins will need physical and occupational therapy that the Salmonese will need to pay for, along with their hospital bills, and Dana created a GoFundMe to help them manage the costs. She also plans to donate a portion to the Twin-Twin Transfusion Syndrome Foundation, to help fund more research into the condition.
Thankfully, though, the babies are doing very well.
“It's such a miracle that nothing is too crazy. They had MRIs to check, and there's abnormalities, but nothing that needs surgical intervention. All their problems seem to be normal preemie issues," Dana says. "They're such miracle baby fighters.”
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