Keeping both baby and mother safe during pregnancy

Despite being high risk, patients felt reassured with specialty care

It was a big surprise when Brianna Tillma learned she was pregnant.

It was an even bigger surprise when she learned she was having twins.

Just as big, was the shift from feeling joy and excitement to worry and anxiety.

sIUGR diagnosis

Shortly after learning the Tillma’s were expecting twins, they unexpectedly were diagnosed with a sIUGR, or selective intrauterine growth restriction. One of her twins was getting more of the placenta than the other.

They sought out numerous doctors, with many telling them cord occlusion, or terminating one of the twins for a better chance of having at least one baby, was their best option.

Find a doctor: Maternal fetal medicine specialists at Sanford Health

“We were never on board with that, and we didn’t feel comfortable with that. We never found a doctor where we felt that we were completely on the same page with,” she said.

Then, they met Dr. Michael McNamara, D.O., a maternal fetal medicine physician at Sanford Health in Sioux Falls, South Dakota.

“We met with him and from day one, we just felt like he heard us from the moment we told him of what we’ve already been through. We just appreciated how personable he was and how he was on the same page as us,” she said.

Sharing goals

From the beginning, Dr. McNamara shared the Tillma’s goal: two babies.

“He told us, ‘I’m here for you, and I’m going to be team two babies.’ That always stuck with me, we were just very thankful for that,” said Tillma.

Related: It’s twins! Prenatal care for multiples

Dr. McNamara specializes in high risk pregnancies. He says it’s his job to inform the family of all possible outcomes.

“They knew there was a chance they could lose both babies, but they were willing to take that chance to save them both,” he said.

Their risk for losing both babies was one in 270.

“So, to say someone had a 10% of losing both babies, that’s a pretty high chance,” he said.

He explained that because Tillma was diligent in following his recommendations, “it turned out well.”

“She did everything we asked her to do throughout the whole pregnancy. She came in many times throughout the pregnancy to be sure the both babies were doing well, and fortunately, we got two healthy babies,” he said.

Feeling safe

Tillma said she felt safe and understood throughout her entire pregnancy. She trusted the specialists and system at Sanford Health.

So did Brooke Welker, a nurse practitioner at Sanford Health who developed HELLP syndrome with her first born daughter, Harlow.

HELLP syndrome, Welker explained, is a complication of high blood pressure during pregnancy.

Because of the complication, she had to deliver Harlow 4 weeks early.

“It was quite scary to go into the hospital feeling as sick as I was in delivering early,” she recounted.

Harlow was born and is now 3 years old. A little over a year later, Brooke learned she was pregnant again.

This time, with twins.

“We were quite traumatized going into the subsequent pregnancy, then having that coupled with being pregnant with twins, it really gave us a lot of anxiety,” she said.

“But, working with Dr. Sierra and Dr. Rodel was excellent. They answered all of our questions and made us feel really safe along the way,” she added.

Collaborating care

Welker started her care with Dr. Anthony Sierra, M.D.  She had worked with him at Sanford, and knew he was a provider she felt comfortable going to.

Once she established care with Dr. Sierra, and they learned Welker was pregnant with twins. Dr. Sierra referred Welker to maternal fetal medicine, “to collaborate with for my care,” she said.

She was referred to Dr. Rachel Rodel, M.D., who says what makes pregnancy care at Sanford Health so special is the ongoing dialogue between departments.

“Our team gets together in a large meeting and discusses patients to make their care seamless and allow them to have the most information they can, because so many things are unpredictable at the time of delivery with high risk pregnancies,” she said.

Welker’s children are all healthy, and so is she.

She says pregnancy is a scary time, but you can trust the experts at Sanford Health.

“I would recommend Sanford one hundred percent. I really felt like I had a say in my care while also having providers that were able to confidently execute those wishes within reason.”

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Posted In Pregnancy, Specialty Care, Women's

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