Twins born 135 days apart at Willow Creek Women’s Hospital
11/27/2019
Having just turned three months old, Graham Shawver doesn’t know yet about the extraordinary circumstances of his birth.
He is unaware of his twin brother, Ethan, born at just 18 weeks and too little to survive.
He has no idea what a cervical cerclage procedure is – nor do most people for that matter – or that it saved his life.
But he’ll soon learn that what his mom and her physicians achieved – when he was born a phenomenal 135 days after his younger brother – is among the top world records. In fact, it appears to be just short of the world record for asynchronous delivery of twins (meaning born at different times).
When Erin Burrell-Shawver got pregnant with her twin boys, she suffered hyperemesis gravidarum, an extreme form of morning sickness that causes severe nausea and vomiting. It caused her to lose 15% of her body weight. Because of the severe illness and higher risk that multiple births pose, her obstetrician Dr. Michael Clouatre referred her to Dr. Bernard Canzoneri, the region’s only board-certified maternal-fetal medicine specialist.
But at just 18 weeks into her pregnancy, Erin’s water broke with “Baby A,” already named Ethan by Erin and her husband Chase. Dr. Canzoneri rushed to Willow Creek Women’s Hospital near midnight to very carefully deliver Ethan while attempting to save Graham. At just 9 ounces, Ethan was not able to survive. But the steps Dr. Canzoneri took next saved Graham’s life.
He gave Erin medications to stop her labor, performed a procedure called an amniocentesis to rule out infection, and quickly placed a cervical cerclage, stitching up Erin’s cervix to help slow or prevent the premature birth of Graham. The cervix is the lower part of the uterus that opens to the vagina. Because Ethan and Graham were fraternal rather than identical twins, they were in separate amniotic sacs with separate placentas. Although Ethan had delivered, Ethan’s placenta remained in Erin’s body.
“Typically, this type of cervical cerclage intervention only lasts for about 7-14 days on average,” Dr. Canzoneri explained.
After the procedure, Erin asked Dr. Canzoneri what the stats were for a good outcome for Graham. “He said there weren’t any good stats because this was so rare. He said the procedure might delay Graham’s birth by a couple of weeks. But we defied the odds.”
After the procedure was performed, and Erin went home from the hospital, she went on complete bedrest to minimize the risk of another premature delivery. “At 36 weeks, I was able to get up and move around some. At 36-37 weeks, the cervical cerclage was removed. At 38 weeks my water broke. We went to the hospital right away and Graham was born in 17 minutes.” Dr. Michael Clouatre’s partner Dr. Kent Mason delivered Graham… an amazing 135 days after his brother Ethan had been born.
Dr. Clouatre added, “When Erin delivered Ethan so early she was obviously devastated and scared. However, she was determined to keep Graham inside until he could survive. Few people can appreciate how sick she was, needing daily IV fluids due to her extreme nausea and vomiting. The required strict bed rest also took its toll but every time she came in she was smiling. We saw her much more frequently to make sure we were doing everything possible to help keep Graham inside. With the support of her family she was able to accomplish this life-saving feat. Erin truly is an amazing person. Hopefully Graham will appreciate all it took to get him here.”
Graham came home to a three-year-old sister, Bradlee, who is quite smitten with him, according to mom. The Shawvers live in Gentry where Erin runs Marcy’s Grooming and Boarding.
“Despite loss of one of the twins, this is an absolutely amazing pregnancy outcome,” Dr. Canzoneri said. “The world record for asynchronous delivery of twins is 154 days so we think this may one of the top 5 longest recorded time periods in the world between the delivery of twins.”
*Dr. Michael Clouatre and Dr. Kent Mason, independent members of the Willow Creek medical staff, are affiliated with Creekside Center for Women. Dr. Bernard Canzoneri, a member of the medical staff at Willow Creek, is affiliated with Maternal-Fetal Medicine Center of Northwest Arkansas.
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