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Multiples and High Risk Pregnancy: The Shah's Story

Safe and Sound: Rupal and Her Triplets are Home After Life-Saving Care

Rupal and Ravi Shah with their triplets, Rupal's mom and their two pet dogsRupal and Ravi Shah know a thing or two about medical expertise. “I am blind in one eye and my husband Ravi was born without fingers on one hand,” explains Rupal. Having seen more doctors than they’d care to admit, the Silver Spring couple knows great medical care when they experience it. That’s why when Rupal’s pregnancy became more complex than they ever imagined, the soon-to-be parents came to Holy Cross Hospital for care. “We offer the most advanced programs and treatments available for women with high-risk pregnancies,” says Ann B. Burke, MD, medical director, Obstetrics and Gynecology, Holy Cross Hospital.

Trouble Around the Corner
Any pregnancy with more than one baby creates a higher risk for complications, and Rupal was pregnant with triplets. To make matters more complex, she started to experience swelling about 26 weeks into her pregnancy. “Over time it got worse, and eventually I became so swollen I couldn’t sit or stand without severe pain,” the 33-year-old explains.

Her doctor, Michael Gallagher, MD, perinatalogist, Holy Cross Hospital, admitted Rupal to the hospital’s specialized High-Risk Perinatal Center, where patients receive expert care, 24 hours a day. Dr. Gallagher diagnosed Rupal with preeclampsia.

“This is a medical condition in which hypertension—high blood pressure— arises in pregnancy in association with significant amounts of protein in the urine,” Dr. Gallagher explains. Severe preeclampsia can lead to seizures, stroke, multiple organ failure and death of the mother and/or baby.

It's Time for Triplets
Rupal was initially scheduled to deliver her babies via Cesarean section at 34 weeks, however, her condition became critical at 32 weeks gestation. “The only treatment option for severe preeclampsia is to deliver the baby,” Dr. Gallagher explains. “This situation demanded that the babies be delivered two weeks earlier than planned.”

On June 11, 2011, Dr. Gallagher delivered the Shah’s three children: daughter, Ariya, 3 lbs., 4 oz; son, Dhilan 2 lbs., 10 oz; and daughter, Jasmine, 3 lbs., 1 oz. With the pregnancy and birth behind them, Rupal and Ravi hoped for some respite. But within hours after the babies were born, Rupal began hemorrhaging.

“The staff immediately determined what was going on and rushed me back into surgery to stop the bleeding,” Rupal says. Despite this added surgery, Rupal was able to go home just five days after delivering her triplets. However, the babies needed to stay in the hospital’s Neonatal Intensive Care Unit (NICU).

The premature triplets had complex medical issues requiring specialized care in the NICU. “Overall the girls were doing pretty well, but Dhilan had developed NEC,” Rupal says. Short for necrotizing enterocolitis, NEC is a potentially fatal infection and inflammation of the intestine.

“Our Level IIIB NICU features state-of-the-art technology to care for babies who are born early or have medical complications that require constant observation or care,” says Cyndi Hawley, RN, NICU director, Holy Cross Hospital. Level III NICUs care for the sickest babies and offer the greatest variety of support. Dhilan’s condition was detected early and treated thoroughly without surgery.

“The care in the NICU was superb,” Rupal says. “They were very hands-on, always accommodating and incredibly supportive.”

Exactly one month after her birth, on Monday, July 11, Ariya went home to join her parents. Jasmine was able to go home the following Monday, and Dhilan followed suit just two days later.
All three of the babies and Rupal received care from a Holy Cross Home Care nurse when they went home.

“It was a huge relief to have everyone home and safe, especially after the complications my wife had and the stomach issues with Dhilan,” says proud father, Ravi. “I’m still in utter shock when I see my three children’s faces looking up at me.”

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