The Triplets' Story
Thanks to her obstetricians, and the maternal/fetal experts in The Birthplace at Bridgeport Hospital, this Milford mom gave birth to triplets so big and healthy, they went right into the hospital's well-baby nursery!
Oh Boy! Oh Boy! Oh Boy!
Melissa and Paul Ferrigno wouldn't have been too surprised to learn they were having twins: Melissa's sister has five-year-old twin daughters. So on their first pregnancy visit to obstetricians Joseph Cuteri, MD, and Robert Park, MD, they were almost expecting it.
"During the ultrasound, Dr. Park got this look on his face, and he turned the monitor so he could see better," Melissa remembers. "I said, 'There are two of them, right?'"
But Dr. Park said to Melissa's husband, Paul, "Why don't you go get Dr. Cuteri. I see three babies!"
Melissa, a nurse at Milford Hospital, had mixed feelings. She loved the idea of triplets, but she knew that any multiple birth is considered a high-risk pregnancy. For one thing, mothers of multiples almost never carry their babies a full 40 weeks. Indeed, Melissa's twin nieces were born at 34 weeks, and many triplets are born before 30 weeks.
Beside the possibility of delivering prematurely, there are a number of risks to the mother, including a condition called pre-eclampsia, which is common in multiple pregnancies, and dangerous because it is associated with high blood pressure and problems with several body organs. In short, Melissa and her three babies were going to need careful monitoring for the next seven months. So Dr. Cuteri immediately arranged for Melissa to see Steven Laifer, MD, chief of Obstetrics at Bridgeport Hospital. Dr. Laifer, along with his partners, Robert Stiller, MD, Gina Dunston-Boone, MD, and Gary Kleinman, MD, are board-certified perinatologists, specializing in high-risk pregnancies.
From that point on, Melissa visited Bridgeport Hospital's Antenatal Testing Unit (ATU) every other week to monitor the growth and development of the babies. The ATU offers Level 2 ultrasounds, more detailed than the standard ultrasounds she underwent on alternating weeks in Dr. Cuteri's office. (An ultrasound provides a sound-wave image of the baby and the placenta.) Once a month she had an especially complete 1 1/2 hour ultrasound at Bridgeport Hospital, during which the babies were measured head to toe, the amniotic fluid levels were checked, and her cervix was measured to check for changes that would indicate she might be going into labor.
Although Melissa did not require it, the ATU also provides amniocentesis and chorionic villus sampling, two techniques to diagnose birth defects at an early stage.
Throughout the pregnancy, Drs. Cuteri, Park, and Laifer, along with Dr. Stiller, who is chief of Maternal-Fetal Medicine at Bridgeport Hospital, stayed in close and cooperative touch with each other and with Melissa, making decisions together for the babies' benefit.
Another problem with multiple births is premature uterine contractions. It's normal in the later stages of any pregnancy to have mild contractions every once in a while, but too many can set the stage for premature delivery. So for an hour every morning and evening, Melissa recorded her contractions with a home monitor. "I was limited to six contractions per hour as a threshold number," Melissa says. "If I went over my limit, Drs. Stiller and Cuteri were notified."
To reduce the number of contractions, she received terbutaline, an intravenous medication. It worked. "I only went over my limit once or twice," Melissa recalls.
Then, in her thirty-second week, tests showed that she was developing mild pre-eclampsia. Drs. Cuteri and Stiller decided that she needed to spend the rest of her pregnancy in The Birthplace at Bridgeport Hospital, where she could be continuously monitored.
Melissa's doctors expected her babies to spend some time in Bridgeport Hospital's Newborn Intensive Care Unit (NBICU) after their birth, so "When I was admitted to the hospital, the first thing Paul and I wanted to do was tour the new NBICU," Melissa says. "I hadn't been back since my sister's twins stayed in the unit five years ago. Wow, has it changed! It's so much bigger and brighter!" Melissa and Paul were inspired to see tiny preemies receiving lifesaving care, and they knew their triplets would be in the best hands.
For three weeks, Melissa was in the hospital's Special Care Maternity Program for moms who come for an extended stay. In this unit, she was cared for by dedicated nurses and staff specifically trained in high-risk pregnancies. Here, measures are taken to provide for the high-risk mom's physical and psychological comfort, including ongoing education about baby's progress, special menu selections and snacks, a VCR and videos, headphones and relaxation tapes, and a blank journal to use as a diary. Support from chaplains and social workers is also close at hand.
"Most triplets are born at about 33 weeks," says Dr. Stiller. "As long as Melissa's babies were healthy, our goal was to keep them inside. When we reached 35 weeks, we knew we had accomplished the goal. The babies would be better off outside the crowded womb; it was time to deliver — especially given Melissa's mild pre-eclampsia."
To save stress on the babies, Drs. Cuteri, Park, and Stiller delivered Paul and Melissa's three sons by cesarean section. Jake and Luke weighed 4 lb. 7 oz., and Paul weighed 4 lb. 9.5 oz. — big for triplets. In fact, the boys were so healthy that they didn't go to the Newborn Intensive Care Unit after all. Instead, for the first time in more than a decade, a set of triplets went straight to Bridgeport Hospital's regular nursery.
"It was tremendously exciting to be there at the birth of triplets who were so close to full term, and to care for them in the well-baby nursery," says the Ferrignos' pediatrician, Richard Freedman, MD. "I consider it a triumph of high-risk obstetrics."
Ironically, with the boys doing so well, it was Melissa who was in trouble. After the delivery, her pre-eclampsia worsened. Responding swiftly, her doctors started her on medication to bring her blood pressure down. Instead of going to the Postpartum Unit, she remained in Labor & Delivery for three days of close monitoring. Finally, her pre-eclampsia was conquered.
Four days after the birth, all five healthy, happy Ferrignos made the very crowded car trip home to Milford.
A few days later Paul and Melissa bought a mini-van.
No One Expects the Unexpected, But...
...it's worth noting that everything that happened to Melissa Ferrigno (with the exception of triplets!) could happen to any expectant mother, at any time during her pregnancy. Blood pressure can mount unexpectedly, contractions can begin too soon, hospital stays can be prolonged…. It's good to know that in The Birthplace at Bridgeport Hospital, every mom receives the same level of sophisticated support and care Melissa received.