Conjoined twins from North Carolina who survived separation surgery despite only a two percent survival rate have graduated kindergarten.
Abby and Erin Delaney, 6, were born at 30 weeks in July 2016, conjoined at the head due to a one-in-million developmental defect that occurs when an early embryo is only partially separated in the womb. Together they weighed just six pounds.
In June 2017, the girls underwent a complicated 11-hour procedure to separate their skulls at the Children’s Hospital of Philadelphia (CHOP). Despite the low odds, the operation was a success.
The girls are now developmentally delayed, but their mother, Heather Delaney, said they are both thriving as they approach their seventh birthday.
“When we saw them graduate, it was like we were dreaming,” said Ms Delaney, age 33. “It’s one of those things you think will never come.”
Abby and Erin Delaney were born at 30 weeks separated by their skulls. They only had a two percent chance of survival
The girls are now approaching their seventh birthday and are doing well, despite developmental delays
‘We don’t yet know what they can achieve, so the sky is the limit for them.’
Conjoined twins at the head are known as craniopagus conjoined twins. Doctors told the Delaney family that the chance of having craniopagus twins was one in 2.5 million. According to CHOPit is the least common form of conjoined twins, accounting for about two percent of cases.
About 70 percent of these children are female, and in the case of craniopagus twins, they are always genetically identical and of the same sex.
It’s unclear exactly what causes conjoined twins, but there are two theories. One is fission, in which an early embryo splits into two bulbs but does not separate completely. These spheres then develop independently into conjoined twins.
The second theory is fusion, where an identical twin pregnancy contains two early twin embryo spheres that fuse and meet at a random point.
About 40 percent of these twins are stillborn, and another 33 percent die shortly after birth, often due to organ failure and other abnormalities.
Ms Delaney learned when she was just 11 weeks pregnant that she was pregnant with conjoined twins. She was hospitalized at 27 weeks, but gave birth naturally at 30 weeks.
“When we found out we went into shock first, we had no idea what to think,” she said.
“It’s something you only see on TV, I thought this doesn’t happen to people.”
Erin (left) and Abby (right) graduated from preschool earlier this month, a milestone their parents never thought possible. “I’m so proud of them both,” said their mother, Heather Delaney, 33
Abby and Erin were born on July 24, 2016 at 1:02 a.m. via C-section. They shared a skull, skin and their superior sagittal sinus – a critical vessel that carries blood away from the brain.
Despite being aware of the two percent survival rate, the parents were told that their girls might be eligible for separation surgery after birth. It would be CHOP’s first surgery of its kind due to the rarity of the girls’ condition.
It also had risks — ranging from mild brain damage to death — and the twins underwent several minor surgeries to prepare for their separation.
On June 6, 2017, Abby and Erin underwent 11-hour separation surgery.
The parents said it was ‘hard’, especially with Abby, who had ‘lost 10 to 15 times her blood volume’, Ms Delaney said.
“They replaced her entire body’s worth of blood several times when the surgeons had to cut her sagittal sinus to separate her from Erin.
“The surgeons basically told us that they had never given so much blood to a patient before and that the patient had survived.”
It took five months for both children to finally be released from the hospital to return to their home in Statesville, North Carolina.
The surgery lasted 11 hours and Abby in particular had a touch and go experience. She lost “10 to 15 times her blood volume,” Ms Delaney said. “They replaced her entire body’s worth of blood several times when the surgeons had to cut her sagittal sinus to separate her from Erin. The surgeons basically told us that they had never given so much blood to a patient before and that the patient had survived.’
Both girls have some intellectual disabilities.
Approaching their seventh birthday, Ms Delaney said the little girls are currently around 15 months of development.
They are both nonverbal, but Erin has been walking since she was five, and now Abby is starting to walk too.
“If Abby can run too, I’m in trouble—it’s hard enough chasing one,” Mrs. Delaney said.
Earlier this month, Abby and Erin graduated from kindergarten, a milestone the parents never dreamed of when the twins were babies.
At their graduation, Erin was awarded a “dolphin award” for her “adventurous heart” and love of discovery.
Abby was awarded the “deer award” for being a “merciful friend who treats all people in a gentle and kind manner.”
“I’m so proud of them both,” said Mrs. Delaney.
Although the girls don’t remember their surgery, they see pictures in the house from when they were conjoined. “One day we’re going to sit them down and have a good talk about it – we want them to be proud of who they are and where they come from,” Ms Delaney said.