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A dramatic delivery at Lucile Packard Children's Hospital has saved the lives of twin girls who might not have survived to their first Christmas, the hospital has announced.

Kate and Annie Carlson were born Nov. 7, but they shared the same amniotic sac in their mother's uterus, which is a rare and dangerous condition, hospital officials said.

The twins, who were born to first-time parents Kevin and Allison Carlson of Menlo Park, underwent an emergency cesarean delivery after their umbilical cords had created a knot. The infants were only 30 weeks old, 10 weeks before a full 40-week term.

In normal twin pregnancies, a thin membrane forms to separate the twins; less than 1 percent of U.S. twin pregnancies are monoamniotic. Cord entanglement and compression and resulting blood flow problems kill 20 percent of twins with this diagnosis, hospital officials said.
 
Allison checked in to Packard in October as an inpatient. With no membrane dividing the twins, Dr. Jane Chueh and her prenatal diagnosis and therapy team balanced the risk of Kate and Annie being born prematurely with the risk of a cord entanglement. Doctors delayed delivery as long as possible to prevent the twins from developing lung disease and other complications associated with prematurity.
 
The girls were tiny: Kate weighed just 3 pounds and Annie weighed three pounds, two ounces.

"It was a testimony to the skill of the obstetricians to allow the twins to grow in the womb as much as they did, so that their lungs were able to mature," said neonatologist Dr. William Rhine, whose team cared for the twins in the Neonatal Intensive Care Unit.

The twins could soon be released from the hospital and their parents have their room ready at home.

"We're really grateful. Despite the chaos surrounding our delivery and pregnancy, Packard Children's really put us at ease with their experience and expertise, and it's one of the best holiday gifts a family could ever ask for," Kevin said.

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