When Katerinne learned she was pregnant with twins, she imagined two girls growing up side by side. But early in her pregnancy, that future became uncertain. Her fetal medicine physician in the Dominican Republic, Dr. Ramiro Diaz of Santo Domingo, saw signs of a serious complication.

Dr. Diaz diagnosed the babies with twin-twin transfusion syndrome (TTTS), a life-threatening condition that can jeopardize both twins. Over the following weeks, the imbalance between the babies continued to worsen.

Dr. Diaz spoke plainly to Katerinne, explaining she might not make it to 24 weeks. Even if the babies survived the pregnancy, they would likely be born extremely early. The hospital in the Dominican Republic did not have the level of care they would need.

Recognizing the urgency and complexity of the diagnosis, Dr. Diaz partnered closely with Julianna Sanchez Gebb, MD, a maternal-fetal medicine specialist at Children’s Hospital of Philadelphia (CHOP), to determine the best path forward. Through CHOP’s Global Medicine program, the two physicians worked together to arrange Katerinne’s transfer to Philadelphia, so she could access the specialized fetal and neonatal care her babies would need.

Learning that CHOP is known worldwide for fetal care and neonatal outcomes — and reading about the hospital’s Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment (CFDT) and its survival rates — reassured Katerinne that it was exactly where she needed to be.

“Thank God I chose CHOP,” she says.

Searching for hope

At 18 weeks pregnant, Katerinne arrived in Philadelphia. Her first day of appointments was overwhelming. After hours of scans and tests, the care team sat down with Katerinne to explain what could happen next. If the imbalance between the twins continued to worsen, they said, one baby could become very sick, putting both twins in danger. It was a possibility Katerinne had never imagined.  

Two days later, another ultrasound showed the babies had stabilized. The team believed they could wait and keep watching. 

“They said maybe they could make it,” Katerinne remembers. “That was when I knew this was the best place for my babies.” 

Against early predictions, she carried the pregnancy to 28 weeks and one day. 

A birth surrounded by expert care for TTTS

The twins were delivered by cesarean section in CHOP’s Garbose Family Special Delivery Unit, designed to provide specialized care before and during delivery and in the critical moments after birth for babies with birth defects. Katerinne was terrified. But what she found in the Special Delivery Unit was calm. 

“It was amazing. I was so thankful I was there,” she says. “I was so scared, but a music therapist was there, playing the guitar. She helped me breathe and told me, ‘You’re not alone.’” 

The babies were born tiny and fragile. Luna weighed close to three pounds. Anna weighed just one pound, 10 ounces. 

The twins were taken immediately to an adjoining room where CHOP’s newborn stabilization and resuscitation team was waiting. This team has special expertise in caring for fragile newborns during the critical first hour after birth, known as the “golden hour.”

Despite being the larger twin, Luna needed help breathing right away. Anna held on for a day before she also needed a breathing tube.  

Life in intensive care

For nearly five months, CHOP’s Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU) became Katerinne’s entire world. 

“I was there every day,” she says.  

She formed bonds with other parents from around the world, all fighting for their babies. Together, they became a kind of family. 

But the twins’ N/IICU journeys were very different from each other. 

Anna’s fight to survive

Anna faced crisis after crisis. She developed a blood infection, her lungs collapsed multiple times, and she spent more than a month on an oscillator ventilator. 

For weeks, Katerinne could not hold her daughter because of her fragile condition. She slept with her phone beside her pillow, afraid of missing a late-night call from the hospital. 

One moment stands out. Anna’s oxygen level dropped dangerously low while Katerinne stood beside her bed. Alarms sounded. Doctors and nurses rushed in. 

“I thought I was losing her,” she says. 

A doctor said to her, “I know you’re scared. I’m scared, too. But I’m going to do everything to save your daughter’s life.” 

Anna received blood transfusions and spent months on IV nutrition. She developed liver complications and needed sedation to help her breathe. Each day brought uncertainty. Yet the team never stopped searching for answers. 

At one critical point, when nothing seemed to work, the team tried a new approach with steroids. Within 24 hours, Anna improved enough to come off the breathing tube. Slowly she began to turn a corner. 

Anna was transferred out of intensive care to a step-down unit. Within weeks, she was strong enough to go home. 

Luna’s steady progress

Luna’s path was smoother than her sister’s, though still challenging. She needed breathing support early on but grew stronger with time. 

“She was the lazy baby,” Katerinne says with a gentle laugh. “The machine was breathing for her, and she was fine with that. She didn’t try to breathe until they took the machine away.” 

Luna struggled with reflux and feeding at first, but week by week she improved. Nurses celebrated each milestone with Katerinne. Eventually, Luna was discharged, breathing on her own and taking feeds by mouth. 

A care team that became family

If there is one part of the experience that brings Katerinne to tears, it is talking about the care team, especially the nurses. 

“They’re the greatest people in the world,” she says. “They didn’t just take care of my babies. They took care of me.” 

They held her hand on the hardest days. They taught her how to bathe, feed and care for the girls. They encouraged skin-to-skin care, helping Katerinne bond with her daughters even when they were fragile. During daily medical rounds, they treated her like part of the team.  

“They always asked me first, ‘Mom, how do you think they’re doing today?,’” she recalls. “They made me feel important. No one knows your babies more than you.” 

Social workers helped her secure housing at the Ronald McDonald House near the hospital, and a psychologist supported her through the fear and stress of the long hospitalization. 

Home, together at last

Today, both girls are home and growing. Anna no longer needs oxygen support and is now breathing regular air on her own, while continuing to learn to eat by mouth. Luna explores the world with curiosity and energy. Every milestone now feels like a huge accomplishment. Even sleepless nights feel like gifts. 

“Even when they wake up every two hours, I just look at them and think, ‘Thank God I have my babies here.’” 

She is saving their tiny hospital bracelets. One day, she will tell them the full story of how they fought to survive. 

“For me, they are miracles,” she says. 

A bond that will last a lifetime

Though Katerinne’s home is far from Philadelphia, part of her heart remains there. 

“That team saved their lives,” she says. 

She plans to return to Philadelphia for the Center for Fetal Diagnosis and Treatment’s annual Lori J. Howell Fetal Family Reunion, where former patients come back to celebrate how far they have come.

“I want them to see the girls now,” she says. “Healthy and thriving.”