Groundbreaking In-utero Surgery Saved Mila and Ciela
November 3, 2022
Surgery was Mila and Ciela's best possible chance of survival after being diagnosed with twin-to-twin transfusion syndrome, a rare condition affecting the connections of blood vessels in the placenta.

Nicole had enough to worry about when she and her husband, Ari, found out they were having twins. Buying a new car, maybe even a new house – and the logistical challenges of going from one kid to three. She worried about what would happen after she delivered, not before.
“We just thought we were having a normal pregnancy,” she says.
But then she began experiencing intense contractions when she was 22 weeks pregnant. Her doctor ordered an ultrasound and then referred her to the Colorado Fetal Care Center at Children’s Hospital Colorado.
That’s where Nicole learned that her babies had developed twin-to-twin transfusion syndrome (TTTS), a rare condition affecting the connections of blood vessels in the placenta. Mila, the larger of the twins, was getting an overwhelming share of amniotic fluid and placental blood, causing her system to work overtime to process it. The smaller baby, Ciela, lacked fluid and blood, causing her body to wither.
“The diagnosis was emotionally draining, but the care team helped us every step of the way,” Nicole says.
With TTTS, the mortality rate for both twins is extraordinarily high without treatment. Fortunately, Nicole learned that Children’s Colorado is home to some of the world’s foremost experts in a groundbreaking procedure known as a fetoscopic laser ablation. This meticulous in-utero surgery uses a laser to eliminate the vascular connections between twins, thus rebalancing the fluid and blood supply – all in a matter of minutes.
Nicole and Ari knew immediately that the surgery offered their girls the best possible chance of survival.
“My husband and I didn’t even talk about it,” Nicole says. “We just looked at each other and knew we had to get it done.”
The procedure worked, and Mila and Ciela were born at 32 weeks gestation. Each weighing less than three pounds, both girls spent about a month in the Neonatal Intensive Care Unit at Children’s Colorado for stabilization and management.
Seven years later the twins are thriving — nothing about them suggests they experienced life-threatening trauma before they were born. Silly, funny and full of life, the girls are both quite active and love doing aerial yoga. Mila wants to be either a hair stylist or a veterinarian when she grows up, while Ciela wants to be a make-up artist.
“The staff at the Colorado Fetal Care Center saved the lives of our girls, and we will support them in any way possible,” Nicole says.