Less than two months after being separated from her sister Hope in a seven-hour surgery at Texas Children’s Hospital, Anna Grace Richards got to go home.
Anna was discharged from Texas Children’s on March 2 after spending 428 days in the hospital. Hope is expected to be able to go home in the near future. The formerly conjoined identical twin girls were successfully separated at Texas Children’s Hospital on January 13. A multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties performed the seven-hour procedure.
The girls were born on December 29, 2016, at Texas Children’s Pavilion for Women, weighing a combined 9 lbs. 12 oz. Delivered via Cesarean-section at 35 weeks and five days gestation, Anna and Hope were conjoined at their chest and abdomen, through the length of their torso and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts. They were welcomed by their parents, Jill and Michael, and older brothers Collin and Seth.
The Richards family, from North Texas, learned Jill was carrying conjoined twins during a routine ultrasound. The family was then referred to Texas Children’s Fetal Center, where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care. They temporarily relocated to Houston in order to deliver at Texas Children’s and be close to the girls during their hospital stay. For the past year, Anna and Hope have been cared for by a team of specialists in the level IV and level II neonatal intensive care units (NICU).
The Richards family will remain in Houston until Hope is able to go home.
Click here to read a more detailed story, to watch a video and view a photo gallery below about the separation of Anna and Hope.
February 13, 2018
On January 13, Texas Children’s successfully performed its fourth conjoined twins separation, giving identical twin girls Anna Grace and Hope Elizabeth Richards a chance at a normal life.
The 7-hour procedure was performed by a multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties. Click here to see a list of surgeons, clinicians and nurses in the operating room during the milestone procedure, and here to view a photo gallery documenting the twins’ journey the day of their separation.
“The success of this incredibly complex surgery was the result of our dedicated team members’ hard work throughout the last year,” said Surgeon-in-Chief and Chief of Plastic Surgery Dr. Larry Hollier. “Through simulations and countless planning meetings, we were able to prepare for situations that could arise during the separation. We are thrilled with the outcome and look forward to continuing to care for Anna and Hope as they recover.”
The girls were born on December 29, 2016, at Texas Children’s Pavilion for Women to their parents Jill and Michael, and two older brothers Collin and Seth. Weighing a combined 9 lbs. 12 oz. and delivered via Caesarean-section at 35 weeks and five days gestation, Anna and Hope were conjoined at their chest and abdomen, through the length of their torso and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts.
The Richards family, from north Texas, learned Jill was carrying conjoined twins during a routine ultrasound. The family was then referred to Texas Children’s Fetal Center, where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care. They temporarily relocated to Houston in order to deliver at Texas Children’s and be close to the girls during their hospital stay. For the past year, Anna and Hope have been cared for by a team of specialists in the level IV and level II neonatal intensive care unit (NICU).
Planning and preparation
During much of that time, medical staff prepared for the separation, using extensive imaging with ultrasound, echocardiography, CAT scans, magnetic resonance (MRI) and even a virtual 3-D model of the girls’ anatomy. Closer to the surgery date, almost 50 medical personnel involved in the procedure participated in a lengthy simulation of the separation.
“These are the kind of procedures you plan for the worst and hope for the best,” said Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Oluyinka Olutoye. “We were blessed that this was the best case scenario. Everything went very well. The procedure was as well as we could have hoped.”
The Richards family is grateful to Texas Children’s for the care provided to their daughters since they found out they were expecting conjoined twins.
“We’ve thought about and prayed for this day for almost two years,” said the girls’ mom, Jill Richards. “It’s an indescribable feeling to look at our girls in two separate beds. We couldn’t be more thankful to the entire team at Texas Children’s for making this dream come true.”
Anna and Hope are recovering in the CVICU and expect to be released to a regular room soon. Both girls will face additional surgeries in the future to ensure their chest walls are stabilized. Otherwise, doctors expect them to lead normal lives.
“What we try to do here at Texas Children Hospital is essentially provide our patients with as normal of a life as we can,” said Pediatric Plastic Surgeon Dr. Edward Buchanan. “I think in this case with these two little girls we were able to achieve that.”
A history of success
The Richards separation is the fourth conjoined twins separation performed at Texas Children’s. The first pioneering procedure occurred February 16, 1965, when a team of surgeons separated 9-week-old conjoined twins Kimberly and Karen Webber. The Webber twins were connected at the liver and pericardium. The second separation happened on June 9, 1992, when Texas Children’s surgeons successfully separated Tiesha and Iesha Turner, who were 1 year old and shared a sternum, liver, entwined intestines and fused organs.
The third conjoined twins separation happened nearly three years ago on Feb. 17, 2015, when a team of more than 40 clinicians from seven specialties separated 10-month old Knatalye Hope and Adeline Faith Mata during a marathon 26-hour surgery. The twins were connected from the chest to the pelvis and shared a chest wall, pericardial sac, diaphragm, liver, intestinal tract, urinary system and reproductive organs. Today, Knatalye and Adeline are almost 4 years old and are doing very well, walking, talking, even learning how to ride a bike.
Since Texas Children’s opened its doors in 1954, multiple sets of conjoined twins have been referred to the hospital for consideration. However, in many of these cases, separation was not medically possible. Olutoye, who has participated in five conjoined twins’ separation surgeries, two at Texas Children’s Hospital and three at the Children’s Hospital of Philadelphia, said he and a team of experts from various specialties look at every case very closely and consider many factors before deciding how to move forward.
“Separating conjoined twins takes a tremendous commitment,” Olutoye said. “We all are privileged and honored to be part of each and every case, especially the ones where we can help.”
January 23, 2018
Texas Children’s continues to deliver on its mission of providing quality and safe care to our patients. As part of the expansion of the Maternal Fetal Medicine services at the Pavilion for Women, the obstetrics service has partnered with the Texas Children’s Kangaroo Crew to create the Maternal Transport Service.
The Kangaroo Crew transport team has decades of experience in critical care transport. To ensure expertise in high risk obstetrics care, the Kangaroo Crew and the Pavilion for Women labor and delivery (L&D) nursing staff have combined their specialized experience to create a program that supports critically ill obstetrics and gynecology patients. The team consisting of a Kangaroo Crew nurse, L&D nurse, respiratory therapist and EMT can provide specialty care not only to newborns and children, but now to mothers while enroute to the Pavilion for Women.
On December 8, 2017, Texas Children’s had its first maternal fetal transport case where a high-risk pregnant patient was transported to the Pavilion for Women from an outside hospital. The transfer call came in to Texas Children’s Mission Control, the hospital’s state-of-the-art communications hub that houses representatives from the departments of Room Management, Transport Services and Critical Care.
When a transfer call comes into the center, teams across the system work together to assure an efficient transfer occurs that provides the highest quality and safest care possible for high risk maternal patients.
“Whenever safe to do so, transporting a pregnant patient to the appropriate facility before an emergency happens is safest,” said Dr. Karin Fox, medical director of Maternal Transport. ”There is not an incubator yet made that can support an unborn baby and the mother, provided she is stable and a true emergency has not yet occurred.”
Prior to the maternal transport, meticulous collaboration took place before coordinating the patient’s successful transfer to the Pavilion for Women.
“We collaborated with our Maternal-Fetal Medicine and subspecialist teams to determine if this patient would benefit from maternal transport,” said Elizabeth Bolds, assistant clinical director at the Pavilion for Women. ”Intake assessment revealed this would be an ideal candidate for our Maternal Transport program and as such we coordinated the patient’s transfer to the Pavilion for maternal ICU care.”
The Kangaroo Crew staff – Shannon Frost RN, Heidi Allen, RRT, Nathan Martinez, EMT, along with maternal transport nurse, Khanh Nguyen, comprised the pioneering team that transported our first maternal transport.
According to Deb D’Ambrosio, RN, director of Transport Services and Mission Control, and Dr. Jeanine Graf, medical director of the Kangaroo Crew, “we had six successful transports in the first few weeks of starting the program. We anticipated this would be the volume for one month.”
By extending this transfer service beyond the hospital’s pediatric and neonatal populations to our high-risk expecting mothers, the Pavilion for Women continues to bolster its reputation as a primary referral site for patients with high-risk pregnancies.
“When the Pavilion for Women opened five years ago, it was created to care for the most complicated pregnancies and critically ill newborns, as well as serve thousands of normal deliveries each year,” said Cris Daskevich, senior vice president at the Pavilion for Women. “By working with our Kangaroo Crew and Mission Control partners, this transport service allows us to help our partners in the community transport their really sick patients to us where we can improve outcomes for mothers and babies.”
Click here to learn more about high-risk pregnancy care at Texas Children’s Pavilion for Women. Click here to learn more about our Kangaroo Crew transport team.
January 17, 2018
Texas Children’s Pavilion for Women has earned the coveted Blue Distinction Center for Maternity Care designation for its expertise in the delivery of safe, efficient, high quality care to women and newborns.
As a leader in obstetrics, gynecology and fetal intervention, the Pavilion for Women specializes in high risk pregnancies and provides a continuum of care to women during every stage of their reproductive lives. To become a nationally designated Maternity Specialty Care Center, Blue Cross Blue Shield (BCBS) evaluated the Pavilion for Women on a variety of quality and patient satisfaction measures.
The BCBS noted the Pavilion for Women’s successful implementation of evidence-based breastfeeding practices to ensure our nurses, obstetricians and pediatricians are well trained to teach mothers how to breastfeed and maintain lactation to give newborns a healthy start.
The Pavilion for Women excelled in maternity quality measures including the rate of episiotomies performed and the administration of antenatal steroids, which are medications given to pregnant patients who are at risk for delivering their babies too early. The hospital has consistently exceeded the national target rate of 90 percent or above for antenatal steroid administration.
The Pavilion for Women received exceptional marks in patient satisfaction. The hospital’s improvement efforts are directly related to the feedback received through the patient satisfaction survey. In September 2017, the Pavilion for Women achieved a patient satisfaction score of 92 percent and a 93 percent score for both pain management and care instructions that are given to patients before their hospital discharge and at the end of their clinic visit.
“We are grateful to our team’s collaboration in helping us achieve this designation,” said Texas Children’s Pavilion for Women Senior Vice President Cris Daskevich. “By reaching this milestone, we ensure that we continue to meet the standard of care and excellence that our patient families have come to expect.”
Click here for more information about the Blue Designation Center for Maternity Care designation.
November 14, 2017
Texas Children’s has touched clinical social worker Melanie Pearson on many levels. The organization has given her the job of her dreams. More importantly, the organization and its staff saved the lives of her two sons.
Shortly after delivering her oldest son at Texas Children’s Pavilion for Women, he was diagnosed with a heart condition. “How fortunate we were to be at one of the greatest teaching hospitals in the country,” Pearson said.
Pearson’s second son came only 14 and a half months later, a month before he was due. Shortly after birth, he was taken to the NICU and cared for by the hospital’s neonatology team. Pearson was only able to hold her newborn son for a few minutes before they had to be separated.
“Only a mother can understand that pain,” she said. “I would not have made it through without my amazing OBGYN and her team. She was the calm in the storm keeping my husband and I updated every step of the way and taking the time to listen and calm our fears.”
Both of Pearson’s sons are doing well today because of the care they received at Texas Children’s. As a result of that care, Pearson said she’s been searching for a way to give back and found it when she learned about the Chevron Houston Marathon’s Run for a Reason charity program.
Texas Children’s Hospital is an official charity for the Houston Marathon and Armaco Half Marathon, taking place on Sunday, January 14, 2018. The Run for a Reason program is a way for runners to run the race of their choice with a guaranteed entry – on behalf of a charity.
“Running for Texas Children’s Hospital is not just about the race, it’s a promise to our patients,” said Eric Blackwell, manager of special event for Texas Children’s. “By signing up to run and fundraise on behalf of Texas Children’s Hospital, your donations will directly impact the lives of countless children. Your race will become the race for our patients who are too sick – sometimes too sick even to play outside. Your support will allow us to expand our care to even more children who need our help.”
Pearson signed up to run the half marathon and said becoming a charity runner was the least she could do to in her effort to repay Texas Children’s for what the hospital has done for her and her family.
“I see it as a small way I can give back to a place that has given me and my family so much,” she said. “I am dedicating this race to the three most important men in my life. My husband and two sons. They are my rock and I wouldn’t be who I am today without them.”
To join Pearson and the Texas Children’s Running Team, click here. To help Pearson and others on the team meet their fundraising goal, click here. And, to volunteer to cheer these awesome runners on the day of the race, Sunday, January 14, click here.
Cheerleaders will be set up between miles 5 and 6, and a Texas Children’s Hospital tent will be stationed in the Bed Bath & Beyond parking lot at 3102 Kirby Drive between Richmond Avenue and West Alabama Street. Cheering begins at 7 a.m. until all runners pass the Texas Children’s tent. Snacks, sign-making materials and T-shirts will be provided to all individuals who sign up to volunteer.
October 17, 2017
Kristen Marie Hersey, RN, Women’s Services, passed away on July 30, 2017 at the age of 33.
Kristen was a member of the inpatient Women’s Services Labor & Delivery Team. Kristen dedicated her life to helping others and was always willing to help even when exhausted. Kristen loved her job! She considered being a nurse more of a calling than a job. Kristen cherished being able to help others bring life into the world and had a pure joy for every baby born. Kristen cared for so many people and made friends wherever she went. Kristen loved her children more than anything, and taught them to pray and thank God for all of our gifts and made sure they knew how much they are loved. Kristen was a friend to all, her loving personality, giving spirit, listening ear, and that smile that could light up the unit will be greatly missed by her team and fellow employees.
Kristen is survived by her loving husband, Shawn; children, Isla and Rowan; mother, Lisa; father, James; stepfather, Mark; Mother- and Father-in-law, Tammie and Gary; sisters, Trina Ouztz (husband, Matt) and Alli Combs (husband Drew); Sister-in-law, Kati; nieces and nephews, Emma, Liam, Eli, Lily Anne, William, Grady, Layton, Allison, Austin, Abigail; and many other loving family and friends.
October 10, 2017
Texas Children’s collaborative work to develop a novel device to anchor the chorio-amniotic membranes during fetal surgery was recently funded by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD) of the National Institutes of Health (NIH).
Partnering with Baylor College of Medicine, the Department of Bioengineering at Texas A&M University, and local life sciences commercialization firm Fannin Innovation Studio, the $225,000 Small Business Innovation Research (SBIR) grant will be used to advance the development of a device that can be introduced into the uterine cavity under ultrasound guidance to anchor the chorio-amniotic membranes, thereby reducing the risk for premature rupture of membranes (PROM) during fetal surgery.
Preterm PROM is the most frequent complication associated with fetal surgery and can increase the risk of premature delivery that could potentially add the insult or prematurity to the fetal anomaly that leads to the need for fetal surgery.
Through the Texas A&M undergraduate and graduate design program, a group of Texas A&M engineering students collaborated with Dr. Jimmy Espinoza and OB/Gyn-in-Chief Dr. Michael A. Belfort, obstetricians and gynecologists, and fetal surgeons at Texas Children’s and Baylor, to create the device in 2016. Espinoza and Belfort challenged the students to develop innovative tools that could be percutaneously introduced into the uterus during fetal surgery to anchor the chorio-amniotic membranes in order to reduce the risk of preterm PROM.
Fetal surgery is a relatively new discipline that aims to reduce the risk for fetal death in conditions such as twin-to-twin transfusion syndrome, severe fetal anemia, congenital diaphragmatic hernia or fetal hydrops, or reduce the long term complications and improve the quality of life in conditions such as spina bifida. Texas Children’s and Baylor are at the forefront on fetal surgery in the U.S. and have innovated techniques to make fetal surgery safer for the mothers and their unborn children.
After extensively collaborating with Texas Children’s surgeons to understand the challenges of anchoring the chorio-amniotic membranes during fetal surgery and the need for refinement, the collaborative team developed a device that can be percutaneously introduced into the uterine cavity under ultrasound guidance in order to anchor the chorio-amniotic membranes to reduce the risk for preterm PROM. This new innovation in fetal surgery could potentially be used in all fetal surgeries because of its percutaneous approach and should reduce the risk for the most common complication associated with fetal surgery, namely pre-term PROM.
“The development of new devices and new approaches in fetal surgery is very important to make fetal interventions safer not only for the fetus but also for the mother,” said Espinoza, co-director of the Fetal Center at Texas Children’s. “The decision to proceed to fetal surgery is very altruistic for the mothers because they will be exposed to risks associated with surgery for the benefit of their unborn child. Thus, we have the obligation to minimize those risks. This award recognizes the academic partnerships that are necessary to advance the frontiers of fetal surgery.”
The team’s invention has won the top prize at Texas A&M University’s 2016 annual Engineering Design Showcase. The project was judged against over 700 students on more than 150 other projects.