Months after being successfully separated at the Children’s Hospital of Philadelphia, two formerly conjoined twins are showing great progress.
Officials at CHOP announced over the weekend that Abby and Erin Delaney are able to sit independently from one another, be held separately in their parents’ arms and are practicing rolling over and crawling.
“Although this has been a long journey, with many ups and downs, Riley and I are thrilled to see how well the girls are doing today,” said Heather Delaney, the twins’ mother. “We are so grateful for the Children’s Hospital of Philadelphia team, and for the support and encouragement that our families, our friends and the community have given us during this long journey.”
That journey began last year when Heather and her husband Riley were told during an ultrasound that the twins they were expecting were joined at the top of their heads due to a condition known as craniopagus, the least common type of conjoined twins, making up about 2 percent of all cases. The couple, who live in Mooresville, North Carolina, were referred to the Center for Fetal Diagnosis and Treatment at CHOP for prenatal care and delivery.
On July 24, 2016, Heather gave birth to Abby and Erin via C-section. The girls were 10 weeks premature and each weighed two pounds and one ounce. Doctors then spent more than two months figuring out how the twins were joined and developed a plan for procedures that would culminate in a separation surgery.
In October, 2016, doctors performed a process known as “distraction,” in which they cut through the bone where the twins’ skulls were joined and then placed a device that would be used to gradually push the two infants apart.
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“Distraction” added one to two millimeters of separation between the two girls each day.
The girls underwent several more surgeries over the next five months and tissue expanders were placed below the skin where their heads were joined. The expanders were gradually filled with fluid to slowly stretch their skin which helped cover the gap when the twins were separated.
As the surgeries and procedures continued, Heather and Riley, with help from the CHOP medical team, took care of the twin girls. The creative ways in which the team helped the girls develop included a specially built swing that held them both.
June 6 marked the big day for the baby girls. An anesthesiology team led by Alison Reed Perate, MD, and Matthew Pearsall, MD, began to prepare the girls for their separation surgery. The team first removed the skin expanders then they separated the blood flow between the two girls, a process that took hours and required the cauterizing of blood vessels and the separation of the dura, which is the covering of the brain that lies under the skull. The surgeons also discovered the girls shared a small amount of brain tissue and separated it as well. After spending hours on the process, they flipped the girls over and performed the same procedure from the other side.
Finally, after more than 11 hours, Abby and Erin were finally separated at 8:43 p.m. that night. The surgeons then replaced their missing skin with artificial material and sewed the stretched skin created by the expanders to cover the gap. In all, around 30 people helped carry out the surgery. It marked the 24th time doctors at CHOP separated a pair of conjoined twins, more than any other hospital in the Western Hemisphere.
“The ability to plan and carry out this type of surgery is testament to the skill and expertise available here at Children’s Hospital of Philadelphia,” said N. Scott Adzick, MD, CHOP’s Surgeon-in-Chief. “I’m extremely proud of Dr. Heuer, Dr. Taylor and the entire CHOP team, and I’m thrilled that Erin and Abby have a promising future because their courageous parents entrusted their daughters to our care.”
After the successful separation, the twin girls began their recovery at CHOP’s Pediatric Intensive Care Unit. They then moved to other units of the hospital before they finally ended up in the rehab unit for occupational and physical therapy. A team of specialists that included surgeons, nutritionists and developmental pediatricians followed the girls’ progress. The girls celebrated their first birthday on July 24 and received more than 300 cards from well-wishers around the world.
Despite the girls’ incredible progress, doctors say their journey is far from over. The girls will need more plastic and reconstructive surgery over the next few years to replace missing bone areas at the tops of their heads, repair their hairlines and reduce scarring. Yet after spending more than a year at CHOP, their parents are now preparing to take them home to North Carolina later this year. Erin was discharged from CHOP while Abby remains at the hospital.
Through it all, the girls have proven to be a major source of inspiration for those following their progress, including their mother.
“The girls are inspiring,” said Heather. “As their parents, it is very neat for Riley and me to have a front row seat to this and watch them overcome these incredible obstacles. We cannot wait to see what their future holds!”
