Danielle de Arakal and her husband Lee already had a 2-year-old at home when they found out they were pregnant with monoamniotic-monochorionic twins, or “Mono Mono” twins. Like any parents, they were filled with all the emotions that come with a growing family and a ton of questions about what having “Mono Mono” twins would mean.

“Mono Mono” twins are rare – occurring in just one of 35,000 to one of 60,000 pregnancies. “Mono Mono” twins share the same amniotic sac and placenta but have two separate umbilical cords, making the pregnancy high risk due to potential complications including lethal umbilical cord entanglement, malnourishment and abnormal blood flow.  

This type of pregnancy has a 50% survival rate until the mother reaches viability, which is the ability of the baby to survive outside of the womb. Fetal monitoring at a hospital significantly increases survival rate once the mother checks in.

“Right off the bat, I was in shock,” says Lee. “The first big surprise being that we were having twins, but then taking in how high risk the pregnancy was, I immediately was worried about Danielle.”

The de Arakal family worked with their obstetrician and perinatologist, Michael P. Nageotte, M.D., Cherese Mari Laulhere BirthCare Center, MemorialCare Miller Children’s & Women’s Hospital Long Beach, to come up with a plan.

Because of the high risk nature of Danielle’s pregnancy, Dr. Nageotte decided to admit her to the Perinatal Special Care Unit (PSCU) at Miller Children’s & Women’s at 27 weeks to monitor the health of the twins.

To help diminish the risks of pregnancy, the PSCU provides multiple different treatments. Equipped with the latest monitoring technology, the PSCU allows for continual observation of any patient’s fetal heart tracing, from anywhere in the unit by nurses and physicians.

Care in the PSCU is led by Maternal-Fetal Medicine specialists, also called perinatologists, like Dr. Nageotte. Maternal-Fetal Medicine specialists are obstetricians that specialize in treating the fetus/baby and mother during high risk pregnancy, labor and delivery or before delivery when the mother and/or baby are at a high-risk for complications, like Danielle.

“The PSCU staff was amazing and immediately I felt comfortable knowing that this is where Danielle was going to be,” says Lee. “As soon as she settled in, her nurses gave me the rundown and they really went out of their way to accommodate me and our 2-year-old, Chloe.”

De Arakal children

Because their stay was during flu season, Danielle and Lee needed a special visitor pass for their daughter Chloe due to visitor restrictions.

“I knew our stay was during flu restriction season and I was really worried,” says Danielle. “I don’t know how I would’ve been able to last that long without seeing Chloe.”

Lee and Chloe were able to visit Danielle every day during her seven-week stay in the PSCU.

“The hardest part really was waiting,” says Lee. “I know it was really tough on Danielle because physically she felt and looked healthy, but she couldn’t leave the hospital.”

On April 18, 2019, at 34 weeks, Danielle gave birth to Grace and Emily de Arakal during her scheduled Cesarean section with Dr. Nageotte.

Grace was born weighing 4 lbs. 15 oz. and Emily weighed 3 lbs. 13 oz. Grace and Emily would need about a three-week stay in the Neonatal Intensive Care Unit (NICU) to increase their weight and ensure their organs were functioning properly.

Luckily for the de Arakal family, Miller Children’s & Women’s is the only hospital in the region to have maternity and neonatal intensive care under one roof. Because of this, Emily and Grace were taken just down the hall after birth, allowing the entire family to stay together.

At other birthing centers without these capabilities, the twins would have had to be transported to another facility to receive specialized care from neonatologists. And visiting family members, like Lee and Chloe, would have to decide where to spend their time.

“We want to thank all of our nurses, doctors, everyone who helped us along the way,” says Lee. “Being able to keep our family together during Danielle’s stay and after when the twins were born, really was a game changer. Knowing that they were just down the hall from us, made the whole experience less stressful.”

Lee and Danielle are back to their every day lives, the only difference is they have two healthy, beautiful additions to their growing family.