Twins survive sharing placenta and sac in North Austin

Miraculous Birth of Monochorionic-Monoamniotic Twins

Nearly 15-month-old twins Emersyn and Suttyn Miller look exactly alike, but they can be distinguished by a purple anklet on Suttyn's foot and a tiny scratch on Emersyn's face. Their parents and younger brother can tell them apart based on their personalities, which are very similar. "They are wild," said mom Megan Ruiz. "And funny."

The twins are monochorionic-monoamniotic (momo) twins, which means they came from the same egg and shared an amniotic sack and placenta. This type of twinning is extremely rare, occurring in only 1% of identical twins and 0.1% of all births.
Dr. Emily Hadley, a maternal fetal medicine doctor at St. David's North Austin Medical Center, said she's only seen about 10 cases of momo twins in her 14-year career. These twins required intense monitoring, as the biggest danger is that the cord to one baby can get tangled with the other baby, preventing good blood circulation to the brain and body. "It can be devastating," Hadley said.

Pregnancy and Birth

Megan Ruiz, 38, was being monitored closely due to a clotting disorder, which had caused two previous miscarriages. At 14 weeks pregnant, an ultrasound revealed the presence of twins. Ruiz was "shell-shocked" and later learned that they were likely momo twins, which would require more monitoring and a maternal fetal specialist. The doctor told her that the chance of the twins going to full-term was "unlikely" and "each week was going to be a gamble." "We were told they were probably not going to make it," Ruiz said.

Ruiz was admitted to the hospital at 23 weeks pregnant and was put on a fetal heart monitor three times a day. She met nurse navigator Barbie McCartney, who helped her adjust to life in the hospital. There were many scares during the pregnancy, but Ruiz was able to help the medical team monitor the babies. "Through it all, Megan actually knew her babies so so well, she would actual help others monitor her," McCartney said.

The goal was to get the babies to 32 weeks, but they were ultimately born by Cesarean section on March 30. Emersyn came out first, "and was loud. She was screaming," Ruiz said. Suttyn came out two minutes later and was quiet but thriving. The twins weighed 4 pounds 4 ounces and 4 pounds 3 ounces and were 17 inches and 17½ inches long.

Life with the Twins

The twins spent 34 days in the neonatal intensive care unit, where they received oxygen support and learned to eat on their own. Ruiz rented a house nearby to be close to the hospital and was eventually able to take the twins home after 96 days. She's learned tricks about having identical twins, such as using different colored ankle bracelets to tell them apart. The girls remain extremely close and often mimic each other. "They are really loving with each other," Ruiz said. "They always want to touch each other, sometimes not nicely, but they are always wanting to be next to each other." Ruiz knows which twin is which, saying, "there's just something about them. I can tell."