Conjoined Twins Successfully Separated at The Children's Hospital of Philadelphia

Shellie Tucker: We went in for my 20-week anatomy scan and the ultrasound tech put the wand on to my stomach and she goes, "What do you think those two circles are?" And it was the girls' heads. And she moved on to say, "You're having twins and I think they're conjoined."

Holly Hedrick, MD: Conjoined twins are very rare. They are predicted to occur 1 in 50,000 births. The majority of those births, however, are stillborn. And the majority cannot be safely separated. Since the first pair of conjoined twins were separated at Children's Hospital in 1957, we've separated over 20 cases. The Tucker twins are actually thoraco-omphalopagus. And so they are joined a little bit at the chest and a little bit in the abdomen. Their chest walls are joined. Their sternum is a single sternum. Their diaphragms are joined. Pericardium is most likely joined. Their hearts are completely separate so it's very, very favorable for the girls.

Shellie Tucker: We decided to come here after we had met with a local specialist and our doctor, our OB, told us that we should definitely come to Philadelphia.

Holly Hedrick, MD: We first met the Tucker family before the girls were born. Our meeting started with a two-day evaluation where they went through a battery of tests that included an ultrasound, an echocardiogram, a fetal MRI. And these tests were sort of souped-up tests of our regular tests because the complexity is exponential when you're talking about two joined. After a huge team meeting, we sat down with them and really explained it from soup to nuts what we thought we saw, what we predicted may occur, and that we actually did indeed feel that they were separable.

Shellie Tucker: We decided this is what our next year is going to be like. We're going to go there. We moved into the Ronald McDonald House and instantly became family with the staff there. And we became family with the staff here at CHOP. We have our 2 1/2-year-old son, Owen, here and the Child Life has been awesome with him, keeping him involved in activities. I mean, the kid doesn't want to sit still. He's a 2-year-old who wants to run. To be seen here and know that I was going to be delivered here, it was incredibly important.

Holly Hedrick, MD: The Special Delivery Unit allowed the parents and the babies to be close by shortly after the delivery. So we could have a planned delivery with a planned resuscitation. And the team that was involved the day that they were born, the team that was involved with the resuscitation becomes the core group of nurse practitioners and neonatologists that are going to be involved with the recovery process once they're separated. So Allison has a team and Emily has a team. We got started around 6 in the morning. The girls were brought upstairs from the NICU. Dr. Bailey and his team met them. There was a team of six anesthesiologists and took them into the operating room and got to work. The team includes general surgery, anesthesia, plastic surgery, cardiac surgery, radiology, OR nurses, bedside nurses, nurse practitioners, psychology, social work, many, many others. That moment where one becomes two is very, very dramatic.

Shellie Tucker: Seeing them together is just the way they are. It's going to be difficult and exciting at the same time to see them as two babies.

Holly Hedrick, MD: We actually have a second set up in the same room and Emily will be taken over to another bed that's waiting and then we'll continue to work. [knock on door]

Shellie Tucker: Hey.

Doctor: Hi.

Doctor: So they did really well. The girls both were awesome through the whole thing.

Holly Hedrick, MD:  I think a day like today makes you realize what an incredible team we have. And it takes such a big team and it takes everybody being on. It takes everything being lined up. It takes everybody being on their best game.

Shellie Tucker: Now it's just the recovery and it's the light at the end of the tunnel.

Holly Hedrick, MD:  The first day that they breathe on their own is huge. The first day that mom can hold them or dad can hold them is huge. The first day that they get feeds again is huge. And then we start the planning for how do we transition from an intensive care setting to a more normal setting and then eventually to home.