Counting her blessings

Angie Tran-Bloom survived to be a mother to her triplets, thanks to hospital’s high-risk maternal-fetal team

September 18, 2011

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.

Conceiving triplets naturally is a rare event in itself, occurring in about one in 8,000 births; identical triplets are even rarer—estimates are as high as one in 500,000 births. 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 one of the nation's top 30 hospitals for gynecology, has the only high-risk maternal-fetal program in Orange County. It also has one of Orange County's highest-level neonatal intensive care units, which means that it was equipped to give Angie and Steven's daughters the kind of care and attention they would need if they were born prematurely. In fact, UC Irvine Medical Center is the only hospital in Orange County with both services under one roof.

"We were very impressed with Dr. Porto from day one," Angie recalls.

After she was referred to him 12 weeks into her pregnancy, Porto met Angie weekly. 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, including 10 weeks of bed rest, Angie was scheduled for a cesarean section on the morning of Nov. 17, 2010.

At 8:30 a.m., Stevie was born first, followed by Lauren at 8:31 and Elise at 8:32. All were healthy and weighed around 4 pounds. But Steven could see in the faces of the doctors and nurses that something was wrong.

"I could see the doctor next to Angie. He was standing in a pool of blood just a minute after the last child was taken out," Steven remembers. "Everyone went into emergency mode."

Angie was losing blood, and quickly. As fast as she lost it, the doctors called for more. Steven already knew that his new babies were in good hands at the NICU, but he hadn't considered how vital UC Irvine's blood bank would be.

Steven 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 mobile blood program and on-site donor center ensured the hospital had sufficient blood for Angie.

Angie's bleeding was caused by a rare placental 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 a complication more common in women who previously have had cesarean sections, no one expected it, explains Porto.

Angie spent nearly 12 hours in and out of the operating room, tended to by a staff of surgeons, anesthesiologists, interventional radiologists and nurses who all worked to stop her hemorrhaging. Dr. Carol Major removed Angie's uterus and one ovary, which was involved in the bleeding.

All told, Angie received 50 units of blood—the equivalent of nearly six people. 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, Steven stood by Angie, who was unconscious for most of her ordeal, keeping vigil at her bedside until she was fully recovered. 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. They are now 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 it." They tell the girls apart with a dab of paint on a big toenail: Stevie has pink, Lauren has blue and Elise is polish-free.

They're 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," says Steven. "Things definitely would have turned out differently."

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