Twin girls Ava and Emma have had quite an adventure in their young lives, one that began before they were even born. Their mom, Carly Decker, a Panama City resident, was pregnant for the first time. Since she knew she had twins on the way, she didn’t really think twice about any of her symptoms. “I was having pain in my groin and was extremely tired,” explains Carly. “I felt like I was bigger than I should have been … but I just chalked it up to having twins.”
Carly had her first maternal-fetal-medicine (MFM) appointment at Nemours Children’s Health, Panama City. The new clinic reestablished MFM services in the area, providing telehealth visits to patients. At 17 weeks, Carly had a consult with Melanie Mitta, MD, FACOG, who reviewed the detailed anatomy scans and diagnosed her with stage-3 twin-to-twin transfusion syndrome (TTTS), a serious condition where one twin gets too much blood to the other, leading to abnormal blood flow that can cause significant health risks for both twins.
Dr. Mitta and the perinatal coordinators worked quickly to get mom a consultation for fetoscopic laser therapy the very next day with Emanual Vlastos, MD, an expert in TTTS, at Orlando Health Winnie Palmer Fetal Care Center. Dr. Mitta helped Carly process the worrying news. “She was compassionate,” says Carly, “and always very calm and throughout my treatment.” Another MFM specialist, Claudia Taboada, DO, also helped Carly. “Both of these doctors took great care of me and made me feel as relaxed as possible in such a scary and uncertain time.”
Carly’s TTTS required surgery while she was pregnant, and Dr. Vlastos performed the fetoscopic laser surgery and amnioreduction, which fixed the blood flow and removed extra amniotic fluid from around the twins.
“I don’t think that I could have been in better hands,” says Carly. “Dr. Viastos was a rock star from the beginning to the end.” The same could be said of the whole staff at Nemours Children’s, Panama City. Mom required weekly TTTS post therapy follow-ups and evaluation by pediatric cardiologist, Daphney Kernizan, DO, for a fetal echocardiogram. “All the nurses and sonographers at Nemours Children’s were absolutely wonderful. I was there once a week (sometimes more), and they were what made every visit a good experience.”
The first couple of weeks after Carly’s surgery were the riskiest. That was the time when the chance of complications was highest, but luckily, there were none. “As I was healing,” says Carly, “I still had over half of my pregnancy to go. My goal was to listen to my body and make sure to rest often. It was scary knowing I still had to make it so far, but I was confident that I would.”
Thanks to the convenient availability and coordinated efforts of both MFM and pediatric cardiology services where she lives, Carly was able to extend her pregnancy to deliver two healthy baby girls in Panama City at our collaborating hospital, HCA FL Gulf Coast, in May of 2024. Her twins Ava and Emma made an early appearance, arriving eight weeks ahead of schedule, but today, they’re both happy and healthy.
With a wealth of experience behind her, Carly has helpful advice for pregnant mothers navigating a similar journey. “Listen to your body and to your doctors,” she encourages. “Have a good support system. The time around the surgery and the following weeks was incredibly scary, but having people by me helped tremendously.” Carly also recommends reading about success stories, which helped her stay uplifted. Finally, she advises remaining positive. “Just know that everything will work out the way that it’s supposed to.”
