Dallas Woman Gives Birth to Healthy Triplets After Two Surgeries During Pregnancy
01/05/2012

DALLAS — For Dallas resident Kerry Shea, getting pregnant last year was one of the most exciting times of her life. It was three times the excitement when Kerry and husband Stephen found out she was carrying triplets.

Baby Kiera, the last of the triplets, went home Jan. 5 from the Special Care Nursery at Texas Health Presbyterian Hospital Dallas. Now reunited with her two brothers, Redmond and Sloan, the three siblings and their proud parents can get on with adjusting to life at home.

But getting there wasn’t so easy.

Dr. Ted Fogwell
Dr. Ted Fogwell said his patient had no side effects from the procedures and no lingering effects following delivery.
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While pregnant with the triplets, Kerry underwent two surgeries by Dr. Ted Fogwell, an OB/GYN on the medical staff at Texas Health Dallas. He performed a surgery to treat a weakened cervix and a later procedure to treat a twisted ovary, which causes severe abdominal pain and destroys the ovary if not properly treated.

“There was added stress because we knew with triplets there would be some potential complications,” Kerry said. “But we never dreamed I’d have to undergo two different procedures.”

Fogwell performed a cervical cerclage, or cervical stitch, to treat cervical incompetence, which happens when the cervix becomes weak and starts to open early in pregnancy. The condition increases the risk of a miscarriage and severe prematurity.

But Kerry’s condition was more complicated than most cases, Fogwell said, because her cervix started to thin out and funnel, and the triplets were causing rapid growth of her uterus with increasing pressure. So he performed a Shirodkar cerclage, a complex type of suturing with a very thick stitch just under the wall of the cervix. The suture is completely buried, reducing the risk of continued inflammation and infection.

Then, a few weeks later, Kerry had severe abdominal pain. With a sonogram by Dr. Brian Rinehart, a perinatologist on the medical staff at Texas Health Dallas, Fogwell saw that blood flow to one her ovaries was cut off by the twisting of the ovary. About 20 percent of ovarian torsion occurs in pregnancy. Delays in treatment can cause loss of the ovary.

To treat the condition, Fogwell performed a laparoscopic procedure to remove the cyst and untwist the ovary. He maneuvered the laparoscopic instruments inside Kerry’s abdomen, which held the triplets.

Despite the complications, Kerry was able to carry Redmond, Sloan and Kiera until week 35 of pregnancy, a good milestone for any triplets, Fogwell said. He decided the babies needed to be delivered via C-section after Kerry showed early signs of HELLP syndrome. The potentially life-threatening condition occurs when a pregnant woman has H (hemolysis, the breakdown of red blood cells), EL (elevated liver enzymes) and LP (low blood platelet counts). The syndrome occurs in about 1 to 2 out of 1,000 pregnancies.

Many women have high blood pressure and are diagnosed with preeclampsia (hypertension during pregnancy) before they develop HELLP syndrome. However, in some cases, HELLP symptoms are the first warning of preeclampsia, a dangerous rise in blood pressure during pregnancy, and, without the usual hypertension, the condition is often misdiagnosed.

“Getting the babies to 35 weeks was really an outstanding outcome,” Rinehart said. “That’s an almost perfect amount of gestational development for triplets.”

Fogwell said that Kerry did fine during the delivery and has had no side effects from the procedures and had no lingering effects from the early HELLP syndrome.

“Kerry and Stephen were very committed to do everything necessary to achieve a great outcome and followed all recommendations,” Fogwell said. “Their participation was critical in the delicate situation.”

“It’s really rewarding to know that the care we were able to provide Kerry, with expert consultants like Dr. Rinehart and minimally invasive surgery, helped her deliver three healthy babies who were each more than 4 pounds,” Fogwell said. “That’s really what this is all about.”

About Texas Health Presbyterian Hospital Dallas
Texas Health Presbyterian Hospital Dallas is an 898-bed acute care hospital and recognized clinical program leader, having provided compassionate care to the residents of Dallas and surrounding communities since 1966. U.S. News and World Report has ranked Texas Health Dallas among the nation’s best hospitals in digestive disorders, orthopedics, and neurology and neurosurgery. An affiliate of the faith-based, nonprofit Texas Health Resources system, Texas Health Dallas has approximately 4,000 employees and an active medical staff of more than 1,000 physicians. For more information, call 1-877-THR-WELL, or visit TexasHealth.org/Dallas.