After having their first daughter, Elle, Marissa and John McDonough fell in love with parenthood. In July 2023, they were shocked to learn they had conceived triplets. As the weeks of pregnancy progressed, some complications arose, and by late September, Marissa, 32, was carrying twin girls they planned to name Jolie and Quinn.
In early October, Marissa began to experience heavy bleeding and was in and out of The Valley Hospital Emergency Department, Valley’s Maternal-Fetal Medicine practice, and her obstetrician’s office to monitor the twins and her health.
“I became severely anemic and had to be admitted to the Labor and Delivery Department multiple times for blood transfusions,” said the Mahwah resident. “By the end of the pregnancy, I’d received a total of 14 units of blood.”
About five weeks after the bleeds began, at the 20-week anatomy scan performed by the Maternal-Fetal Medicine team, Marissa and John learned Jolie's amniotic sac had ruptured and was leaking amniotic fluid. They also learned her placenta had a chronic abruption – a condition that occurs when the placenta separates from the uterus wall before delivery – which was the latest, but not only, source of the bleeding.
“At that point, we began to consult with our care team about options for a path forward. Terminating the pregnancy, while advised as the best option for my health, was out of the question for us until we were left with no choice,” said Marissa. “So, we began to consult with Christiana Farkouh-Karoleski, MD, Associate Director of the Neonatal Intensive Care Unit (NICU) at The Valley Hospital, and the NICU team to discuss Jolie's and Quinn's odds of survival, their outlook, and potential quality of life. Our goal was to be able to carry on the pregnancy until they reached viability. Ideally, we wanted to surpass viability and make it to 28 weeks before we delivered. We were advised that, given Jolie's ruptured amniotic sac and low amniotic fluid, her chances of survival were not good due to concerns about growth and her lung development.”
On November 20, 2023, after a severe bleeding episode, Marissa was admitted to The Valley Hospital. She began steroid and antibiotic treatments with the hope of staying pregnant as long as possible. After more complications, the family and care team made the decision to deliver Jolie and Quinn on Friday, November 24, 2023, at 22 weeks and 6 days of gestation.
“Jolie and Quinn were both born alive, thanks to the excellent work of Paul Dicker, MD, obstetrician and gynecologist, and the Valley Labor and Delivery team, which was the first of many miracles that have since followed,” said Marissa. “Carmela Pane, MD, Medical Director of the NICU at The Valley Hospital; Michelle Lasker, MD, neonatologist; and their outstanding NICU nurses, were able to intubate and get the girls stable, and then they were admitted to The Valley Hospital NICU. Twenty-four hours later, Quinn experienced some respiratory complications and passed away with us at her bedside. We are so grateful to Stacy Rosenblum, MD, neonatologist, and Quinn's NICU nurses for their commitment to her care and their grace, kindness, and support in the final moments we spent with her.”
Jolie’s fight continued on. At birth, she weighed 450 grams, which is less than a pound. At her lowest weight after birth, she weighed 390 grams.
“Growth and nutrition were a critical piece of Jolie’s NICU care. We spent a lot of painstaking hours discussing nutrition; growth; and weight gains and losses,” said John.
Soon after her birth, Jolie was diagnosed with chronic lung disease and a bulk of her care in the NICU was to treat her lungs. She also had a severe case of retinopathy of prematurity (ROP), which is the development of abnormal blood vessels in the retinas that can cause blindness if untreated.
“All of the NICU physicians made every effort to provide Jolie with thoughtful and high-quality care. We witnessed first-hand all of the thought, time, and attention to detail that went into her care plan and know that they collaborated daily to determine the right steps forward for her care,” said John. “We always felt like we were part of Jolie's care experience.”
After 115 days in the hospital, Jolie was released from the NICU on Monday, March 18, 2024, which was five days before her initial due date. She weighed nearly five and a half pounds and was discharged from the NICU on oxygen but weaned off completely after about 4 months. Jolie was diagnosed and treated quickly for ROP and so far, has normal vision.
Today, Jolie is thriving and is a year old, with her corrected age, which is a baby’s age adjusted for prematurity, being between 7-8 months. She loves to eat, is learning to crawl and sit up on her own without support, and has become more vocal. Her big sister Elle is her best friend.
“We are so proud of Jolie and are in awe of her strength, intelligence, and kindness,” said Marissa. “We believe that Jolie was determined to survive, despite her low odds of a good outcome at birth, so that she could come home to her sister Elle and live a full, happy life in honor of her lost siblings.”
Marissa and John share advice for anyone who may be going through the NICU experience:
“We experienced the best and worst outcome as NICU parents - we lost one of our children and brought one home that is thriving. It is not an easy experience, but at the end of it all, you will emerge a stronger and well-rounded parent. Try to be patient as you navigate the difficulties of waiting for your child to grow, overcome health issues, and learn how to eat,” said Marissa and John. “So much is not in your control, but what you can control when you are able to be in the NICU with your baby, is the relationship you can build with them. Talk to your baby. When the time is right, hold and help feed your baby. Help the nurses and doctors to care for them, when possible. They feel your love, and need your love, and it is the best gift you can give them and yourself. Try to also take time away from the NICU to care for yourself, be present with your other children (if you have any), and your family. You are healing from the experience too and owe it to yourself and your children to be well.”
For more information about the NICU at Valley, please visit ValleyHealth.com/NICU.