UCI medical team saves mother of triplets

When Angie Tran-Bloom and Steven Bloom learned they were expecting triplets, their biggest concern was delivering three healthy babies. They never dreamed the pregnancy would nearly cost Angie her life.

The recently married Yorba Linda couple had just adopted a puppy as a trial run for parenthood when they learned, in May 2010, that Angie was already pregnant.

At the first ultrasound, her doctor had another surprise: They were having three identical babies, evidenced by the single placenta they were sharing.

Angie, a math teacher at Huntington Beach High School, and Steven, a criminal defense attorney, had not been undergoing fertility treatment.

Naturally conceived triplets are rare, occurring in about one of every 8,000 pregnancies; naturally conceived identical triplets are even rarer – with estimated odds as high as one in 200 million. Because of the complexity of their case, Angie and Steven were referred by their community hospital physician to Dr. Manuel Porto, a UC Irvine obstetrician/gynecologist who specializes in high-risk pregnancies and multiple births.

UC Irvine Medical Center, ranked among the nation’s top 30 hospitals for gynecology, has the only high-risk maternal-fetal program in Orange County. It also has one of the county’s highest-level neonatal intensive care units, meaning it was equipped to give Angie and Steven’s daughters the kind of care and attention they would need if born prematurely.

“We were very impressed with Dr. Porto from Day One,” says Angie, who met with him weekly from her fourth month on. Thanks to his close monitoring, her pregnancy was largely uneventful, though the 69 pounds she gained were uncomfortable on her slender frame. After carrying the triplets for 34½ weeks –10 of them on bed rest – Angie was scheduled for a Caesarean section on the morning of Nov. 17, 2010.

Stevie was born first, at 8:30 a.m., followed by Lauren at 8:31 and Elise at 8:32. Each was healthy and weighed about 4 pounds. But Steven could tell from the faces of the doctors and nurses that something was wrong.

“I could see the physician next to Angie. He was standing in a pool of blood just a minute after the last child was taken out,” the new father recalls. “Everyone went into emergency mode.”

Angie was losing blood – and quickly. As fast as she lost it, the doctors called for more. Steven knew his daughters would be in good hands at the NICU but hadn’t considered how vital UC Irvine’s blood bank would be.

He puts it bluntly: “What made the difference with Angie – and why I’m not a single father – is that there’s a blood bank on campus.” UC Irvine’s bloodmobile and on-site donor center ensured that the hospital had a sufficient supply.

Angie’s bleeding was caused by a rare complication known as placenta accreta, in which the placenta attaches too tightly to the uterine wall. This prevented her uterus from going back to its normal size after delivery, causing her to continue bleeding.

The condition wasn’t detected in any of the first-time mom’s ultrasounds, and because it’s more common in women who’ve previously had Caesarean sections, no one expected it, Porto explains.

Angie spent nearly 12 hours in and out of the operating room, tended to by surgeons, anesthesiologists, interventional radiologists and nurses who all worked to stem the hemorrhaging. Dr. Carol Major removed her uterus and one involved ovary.

All told, Angie received 50 units of blood – the equivalent of normal blood flow in nearly six adults. When the bleeding was finally stopped, she was treated in the intensive care unit. “There were a number of things she had to overcome. You don’t bounce back from that overnight,” Steven says.

Through it all, he stood by Angie – who was unconscious for most of her ordeal – keeping vigil at her bedside. As she got better, NICU nurses made sure Angie had time with her girls, bringing them to her for cuddling, feeding and diaper-changing practice.

Two and a half weeks after the births, Steven brought Angie, Stevie and Elise home; Lauren joined them a few days later.

Angie’s medical team is amazed by her recovery. “You’d never know she had any problems,” Porto says. “I’m absolutely delighted with her progress.”

The triplets are thriving too. Now 11 months old, they’re sitting up and teething. Angie and Steven are reveling in their new role as parents, joking that “anything they sell at Babies R Us we’ve got three of.” They tell the babies apart with a dab of paint on a big toenail: Stevie has pink, Lauren has blue and Elise is polish-free.

The couple are grateful the girls were born at UC Irvine. “It’s abundantly clear that if Angie wasn’t at UC Irvine, I’d be raising three kids on my own,” Steven says. “Things definitely would have turned out differently.”