• 2018 Annual Report

Texas Children's 2018 Annual Report

Texas Children’s experts successfully separate conjoined identical twins

Kimberly and Karen Webber were the first in 1965.
Next were Tiesha and Iesha Turner in 1992.
And then Knatalye Hope and Adeline Faith Mata grabbed the world’s attention in 2015.

What do these pairs of sisters have in common? Each was a pair of conjoined twins successfully separated at Texas Children’s Hospital. And on January 13, 2018, experts at Texas Children’s performed our fourth twin separation, giving identical twin girls Anna Grace and Hope Elizabeth Richards a chance at a normal life.

The seven-hour procedure was performed by a multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties.

“The success of this incredibly complex surgery was the result of our dedicated team members’ hard work throughout the last year,” said Surgeon-in-Chief Dr. Larry Hollier. “Through simulations and countless planning meetings, we were able to prepare for situations that could arise during the separation. We are thrilled with the outcome and look forward to continuing to care for Anna and Hope as they recover.”

Jill Richards and her husband, Michael, of northern Texas, first learned they were expecting conjoined twins during a routine ultrasound. They were then referred to Texas Children’s Fetal Center, where they underwent extensive prenatal imaging and received multidisciplinary consultation from experts at Texas Children’s to help develop safe prenatal, delivery and postnatal care plans. The family relocated to Houston in order to deliver at Texas Children’s and to be close to the girls during their hospital stay.

Anna and Hope were born December 29, 2016, at Texas Children’s Pavilion for Women. Weighing a combined 9 lbs. 12 oz. and delivered via cesarean-section at 35 weeks and five days gestation, the girls were conjoined at their chest and abdomen, through the length of their torso, and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts. In the months from their birth until the separation surgery on January 13, 2017, Anna and Hope received care from a team of specialists in the level IV and level II neonatal intensive care unit (NICU).

Planning, preparation and collaboration

Medical staff prepared for the intricate separation procedure using extensive imaging with ultrasound, echocardiography, CAT scans, magnetic resonance (MRI) and even a virtual 3-D model of the girls’ anatomy. Closer to the surgery date, almost 50 medical personnel involved in the procedure participated in a lengthy simulation of the separation.

“These are the kinds of where procedures you plan for the worst and hope for the best,” said Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Oluyinka Olutoye. “We were blessed that this was the best-case scenario. Everything went very well – as well as we could have hoped.”

As part of their recovery, both girls required care in the cardiovascular intensive care unit. On April 25, 2018, Hope was discharged after spending 482 days in the hospital. She joined her sister, Anna, who was discharged on March 2.

Both girls will face additional surgeries in the future, but doctors expect them to lead normal lives. The Richards family is grateful to Texas Children’s for the care provided to their daughters since they found out they were expecting conjoined twins.

“We are so excited for Hope and Anna to be home with their brothers,” said the twins’ mother Jill Richards. “Our family is eternally thankful for the doctors, nurses, child life specialists, physical therapists and many others at Texas Children’s who took incredible care of our precious girls.”