FOR IMMEDIATE RELEASE
NEW YORK, November 29, 2004

TWINS, SAFE DELIVERY AND GOOD OUTCOMES GO HAND IN HAND AT JACOBI

With the recent delivery of twins by famed actress Julia Roberts, noted neonatologist Ivan Hand says that because of today’s medicine, giving birth to twins can, more than ever, be a time of joy and celebration. “Once a mother knows that she is going to have more than one baby, certain changes need to be quickly made in the program of prenatal care she undergoes, said Dr. Hand, Director of Neonatology at Jacobi Medical Center.

Over the past decades, the advent of sophisticated care has greatly improved the chances of good outcomes for premature and multiple deliveries. Because many multiples are small and born early, they may be initially cared for in a special care nursery called the neonatal intensive care unit (NICU). Jacobi Medical Center offers one of the finest such units in the nation.

Possessing the latest in medical technology, the NICU further extends the frontier in lowering mortality and morbidity for pre-term infants. Electronic equipment has the ability to take over for bodily functions which are not yet working. Major advances include isolettes that closely reproduce the intrauterine environment. The lungs of premature babies are often not able to assume their function, a condition called Respiratory Distress Syndrome (RDS). High-frequency ventilators are used to breathe for babies too tiny to breathe on their own, delivering as many as 900 breaths per minute while allowing the babies to take their own breaths whenever they are able to do so. Nitric oxide, a newly approved therapeutic gas can be used to increase blood flow to the lungs. Surfactants can be given to help the air sacs in the lungs expand and take in more oxygen. As the surfactant takes effect, use of the respirator can gradually be reduced.

For babies requiring transport to Jacobi, a specially equipped infant transporter, with its own ventilator, heating system, humidifier, and monitors is available.

Medical, developmental, cognitive and psychosocial issues that had previously afflicted such babies are greatly reduced. Once babies are able to feed, grow, and stay warm, they can usually be discharged. Other babies, that are healthy at birth, may need only a brief check in a special care nursery. Once mother and baby are home, breastfeeding multiples is certainly possible and encouraged. Jacobi offers lactation specialists that teach mothers techniques for breastfeeding their babies.

The Management of multiple pregnancies may include the need for increase nutrition as mothers that carry two or more fetuses need more calories, protein, and other nutrients. Higher weight gain is also recommended for multiple pregnancies as women carrying twins gain at least 35 to 45 pounds. More frequent prenatal visits can be required to monitor progress. Some women may also need bed rest beginning in the middle of the second trimester.

As multiple pregnancies are considered “High Risk,” the way in which delivery is managed depends on many factors. In twins, if both fetuses are head-down and there are no other complications, a vaginal delivery is possible. Most other positions, and certainly triplets are born by cesarean section. Even vaginal delivery may take place in an operating room because of the greater risks for complications during birth and the possible need for cesarean delivery.

Of course, there are many social and financial implications to instantly bringing more than one newborn into any family. Donna Geiss, Associate Director of Nursing at Jacobi says that, “families with more than one baby need every bit of help they can get. Staff at Jacobi is able to link family with a wide range of support services to ease the transition.” Coping with one newborn is certainly a difficult time for many families, and the frequent feedings, lack of sleep, and little personal time involving two or more babies can be extremely stressful. Such stress can have a psychological impact on the mother to varying degrees of seriousness, and may require intervention that Jacobi can also provide.

For more information on maternal care services and labor and delivery options offered at Jacobi Medical Center please call (718) 918-5429.

Editors: Dr. Hand is available for interviews about all matters concerning multiple and premature deliveries. Upon request, arrangements will be made to secure the presence of families who have utilized services provided at Jacobi.

Jacobi Medical Center is operated by the New York City Health and Hospital Corporation; the nation’s largest municipal health system; which server 1.3 millions New Yorkers annually, regardless of their ability to pay.