October 8, 1999

Karen Hiltz was 17 weeks pregnant when she learned that she was carrying twins. At the same time, she learned that she had a serious condition called twin-to-twin transfusion syndrome. One baby was receiving too much blood flow from the placenta, while the other baby was not receiving enough. Both babies were in danger.

The prognosis seemed dismal. Hiltz could have serial amniocenteses to decrease the fluid around one baby, but the procedure isn't always successful. If she continued the pregnancy, the twins would be at risk for severe birth defects, says their obstetrician at the MGH, Robert Blatman, MD. The other option was to abort the pregnancy –  not something Hiltz and her husband, Brian, wanted to consider.

A few days later, Karen and Brian Hiltz received hopeful news. Hiltz, an emergency room nurse at Somerville Hospital, was earning her master's degree in nursing and doing a rotation at the MGH. Her clinical supervisor, Donna Jenkins, a clinical nurse specialist in the Phillips House, showed Hiltz a newspaper article that described a procedure done in Florida to correct twin-to-twin transfusion syndrome.

Doctors in Boston were skeptical. But the Hiltzes felt they had little to lose. "We would rather take the risk of trying to save them. And if the outcome was grave, at least we knew we tried," says Brian Hiltz.

The Hiltzes contacted Ruben Quintero, a physician at the Florida Institute for Fetal Diagnosis and Therapy in Tampa. With Hiltz in her 19th week of pregnancy, Quintero performed experimental laser surgery to sever the vessels shared by the twins. The surgery took an hour and left a scar no bigger than a freckle on the mother's abdomen.

The surgery ultimately proved successful. Hiltz recently gave birth at the MGH to two healthy boys, Braden and Blake, both about 7 lbs. and 20 inches long.

While the procedure was successful for the Hiltzes, Blatman cautions that it is experimental and has little scientific data to support it.

"Anybody who's thinking of doing this needs to recognize that the benefit-to-risk ratio is not well documented," Blatman says.

For the Hiltzes, though, the risk was worth it. "I'm just happy that Dr. Quintero is doing this work, and I want other people to know about it," says Karen Hiltz.

"They (the twins) could drive me nuts for the rest of their lives, and I would welcome it," Brian Hiltz says.

The Hiltzes with Blatman, right