‘The OB showed me a second baby—twins! At 33 weeks, I had a feeling something wasn’t right.’: Mom survives HELLP syndrome to deliver twins

“David and I got married in December of 2016 and spent the first few years of our marriage dedicated to our careers, our pets (two dogs and a cat), and traveling our way through our ‘Baby Bucket List.’ Eventually, we decided there was one adventure left that we desperately wanted to embark on together—parenthood.

After trying to get pregnant unsuccessfully for a year, David and I pursued fertility testing and received a diagnosis of ‘unexplained infertility’ back in the fall of 2020. We began interventions in October of 2020, and finally got pregnant in February of 2021 with the help of Clomid and an IUI (intrauterine insemination)!

We had our first ultrasound at 6 weeks, and my OB/GYN showed me one tiny baby with a little flickering heartbeat. And then a few minutes later, a second baby—we were having twins! Due to COVID restrictions, David was waiting in the car in the parking garage, so he found out via text message. I sent him a text saying ‘IT’S TWINS!’ and a picture of the ultrasound screen.

We were nervous about being first-time parents to TWO babies, but we were so excited. We found out we were having fraternal twins—two girls—and they were healthy. Any twin pregnancy is considered ‘high risk,’ so I saw a Maternal Fetal Medicine practice and physician in addition to my regular OB/GYN. We had so many ultrasounds I had a photo album full of pictures by the time the girls were born.

At 33 weeks and 3 days, I started experiencing an increase in Braxton Hicks contractions and a general feeling that something just wasn’t ‘right.’ I’d had a persistent headache and shortness of breath as I had tried to present during my conference calls that day, but neither of these things was outside the realm of ‘normal’ for the third trimester, let alone a twin pregnancy’s third trimester.

Although I was pretty sure there was nothing to worry about, I had a strong feeling I needed to get checked out, so I drove myself to our delivery hospital in the middle of the workday. I remember telling the labor and delivery triage nurse I didn’t feel well and I was sorry if it was a false alarm, and she reassured me she would rather I come in for a hundred ‘false alarms’ than risk having an emergency at home.

My amazing primary OB (the one who helped us through our infertility journey) happened to be on call, and she let me know my blood pressure was a little too high and they had found protein in the urine sample collected upon arrival. I was admitted for the night for monitoring and a ’24-hour urine study’ under suspicion of preeclampsia.

I had to go on a magnesium sulfate drip to prevent seizures, which meant I had to have a catheter since that medication causes dizziness. I also received two steroid shots to help the babies’ lungs mature in case they needed to be delivered early. It was about as fun as it sounds (that is to say, not at all), but I was equally relieved to be safe in the hospital and totally shocked my gut instinct was correct and something WAS actually ‘wrong.’

David had joined me at the hospital after work and spent the night on the tiny and uncomfortable ‘husband couch’ in my hospital room. The next morning, we found out my blood pressure readings were getting steadily worse throughout the night, and I failed my 24-hour urine study miserably. I was admitted for continued monitoring with the goal of making it to 37 weeks—the earliest week the babies would be considered ‘full-term.’

My blood pressure was elevated and my labs weren’t great but also not terrible, so David and I assumed we’d be there for the next few weeks. Three nights later, I started to feel sick and had an even more persistent feeling that something wasn’t right. I had a terrible nosebleed (unusual for me) and felt generally under the weather—kind of flu-like symptoms but without any cough, congestion, or fever. I also noticed I was seeing some ‘floaters,’ though not to the point it was very distracting.

Again, I assumed my anxiety was acting up because I really couldn’t point to anything in particular that was causing me distress, I just knew I didn’t feel well. By this point, my bloodwork was being evaluated every 12 hours and there hadn’t been any significant changes, so I mentioned how I was feeling to my nurse. My blood pressure was still high but not scary high and both babies looked good and passed their nightly monitoring with flying colors, so they gave me something to help me sleep and I went to bed.

I vaguely remember my nurse coming in for my blood draw when it was still dark outside. Early the next morning, my nurse woke me up by flicking the lights on in my room. She explained my lab results had come back from my early morning blood draw, and they were scary. My liver enzymes were sky high and my platelets had plummeted; I had gone into HELLP Syndrome overnight.

For those of you who, like me, have never heard of HELLP Syndrome, it is an extremely rare pregnancy complication considered to be a variant of preeclampsia. It stands for hemolysis (the breaking down of red blood cells), elevated liver enzymes, and low platelets. The only cure for preeclampsia and HELLP is delivery of the placenta(s), and if left untreated, it can be fatal.

I had felt fine the day before and had sent my mom and David home, so I received this news on my own. As the nurse explained what was going on, she also broke the news to me that we were officially in ‘get-these-babies-out-ASAP’ territory. There was currently a mom in the OR, but as soon as she came out, I was going in for a C-section.

I called David and then my mom to tell them to get to the hospital right away, and thank God they both picked up. To say I was a little frazzled would be an understatement. They arrived at the hospital in record time, and David and I were prepped for surgery. We snapped a picture and said a prayer for continued health and safety, and then it was time to go to surgery.

Eliza Kaye was born at 10:50 a.m. and Olivia Lucille was born at 10:52 a.m. They both weighed 4lbs 5oz. Hearing them cry was one of the most amazing moments of my life! Because they were so premature, they had to go straight to the NICU, but I did get to give them each a kiss on the cheek first.

Recovery for me was slow; I had to go back on the magnesium sulfate drip for another 24 hours, so I didn’t make it to the NICU to see my babies until the following day. It also took about three days for my bloodwork to start to normalize, but eventually, it did start trending in the right direction again.

Both babies spent time in the NICU ‘feeding and growing.’ Because they were so weak and sleepy, our biggest challenge was waiting for them to be able to feed without needing help from their nasogastric feeding tubes to ensure they were getting enough nutrition. Finally, Olivia came home after 21 days and Eliza joined us after 35 days, completing our family of four.

I am beyond grateful for the amazing care we received. I’m also extremely thankful the circumstances were as they were and I was already being monitored when HELLP developed. Many, many women and babies are not so lucky. Preeclampsia.org describes the most common symptoms of HELLP are as follows:

‘Epigastric (abdominal) or substernal (chest) pain, including abdominal or chest tenderness and upper right side pain (from liver distention).

Nausea, vomiting, or indigestion with pain after eating.

Headache that won’t go away, even after taking medication such as acetaminophen.

Shoulder pain or pain when breathing deeply.

Bleeding.

Changes in vision including blurred vision, seeing double, or flashing lights or auras.

Swelling, especially of the face or hands.

Shortness of breath, difficult breathing, or gasping for air.’

In hindsight, I had more symptoms than I knew to look for. But at the same time, none of these things were outside the range of ‘normal’ for the third trimester of a twin pregnancy. The single symptom that still stands out in my memory is the overpowering feeling that something just wasn’t ‘right.’

I didn’t know much about preeclampsia and had never heard of HELLP Syndrome until it happened to me. I would encourage everyone who is pregnant or loves someone who is pregnant to become familiar with these symptoms. Most importantly, Mamas, listen to your body, trust your instincts, and seek medical attention if something doesn’t feel ‘right.’ It could save you or your baby’s (or babies’!) life.”