Heather and Priscilla Rodriguez made headlines in August when they welcomed all-girl quintuplets at Odessa Regional Medical Center in Odessa, Texas—the second recorded set in the U.S. The five baby girls were born via cesarean section at 28 weeks gestation and have since been under the care of the hospital’s NICU team, led by Practice Medical Director and neonatologist Sanjay Patel, M.D. Nearly three months later, the babies have started to head home.
Quintuplets are extremely rare, with only 10 reported sets of five or more babies in 2018, according to the Centers for Disease Control and Prevention. “The natural occurrence of quintuplets is 1 in 45-60 million pregnancies,” said Dr. Patel. However, multiple births are on the rise as more families experience infertility and turn to assisted reproductive technology, such as in-vitro fertilization, in an attempt to conceive. The Rodriguez quints were conceived via intrauterine insemination, as were the Busby quints, the first-ever all-girl quintuplets in the U.S. born in 2015. Alexander Reiter, M.D., a maternal-fetal medicine specialist at Obstetrix-affiliate Houston Perinatal Associates, provided prenatal care for Danielle Busby and delivered the quints at The Woman’s Hospital of Texas. The Busby family stars in TLC’s popular reality TV series, “OutDaughtered.”
Collaboration is key
It was a true multidisciplinary team effort to prepare for the arrival of five babies. Planning began one month before delivery once fetal viability had been achieved. Lindsey McAnear, DNP, RN, NNP-BC, helped lead the massive effort to ensure the team would be ready for the quints’ arrival at a moment’s notice. OB/GYN physicians, neonatal physicians, nurse practitioners and nurses, NICU pharmacists, X-ray technicians and respiratory therapists were all scheduled to be on hand for the delivery. “Everyone knew what their position was going to be, and there was a huge collaboration with all of the departments to make sure everybody was staffed,” said Lindsey. The team thought of every detail—even down to having hats ready to be customized with the babies' names and birth order on them!
When the big day arrived, the group split up into two operating rooms to accommodate all five babies. More than 30 clinical team members were present for the delivery, including two neonatologists, three NNPs and multiple nurses and respiratory therapists. Each baby had a dedicated neonatologist or NNP at the bedside in addition to a respiratory therapist and nurse (or two!). The team worked together seamlessly and had every baby out, intubated and back in the NICU in less than 15 minutes.
Heading home
After a nearly three-month stay in the NICU, the quints are all doing well and have been working hard to meet the developmental milestones needed to discharge—maintaining their temperature, eating and breathing on their own and consistently gaining weight. They’ve also been receiving developmental care, including physical therapy and speech therapy, which will resume on an outpatient basis following discharge to ensure the continued achievement of developmental milestones. Because premature babies are at risk for failure to thrive and many other developmental delays, early intervention is critical to improving outcomes.
The babies’ discharge will be bittersweet for the care team. Since Heather resided in the postpartum unit four weeks before delivering, the care team grew very close to her, and that relationship has flourished with both mothers and, of course, now with the babies. The quints will go home at different times as they each meet their milestones, which can sometimes be more stressful for the parents as they juggle having babies at home and in the NICU simultaneously. It will take a village as Heather and Priscilla embark on this new journey, and the nurses are already lending a hand and signing up to help the family at home.
Once-in-a-lifetime experience
While Dr. Patel had previously cared for quadruplets, this has been a truly remarkable event in his career. “I’m so proud and lucky that this happened in my unit,” he said. “I’m proud of the entire NICU team who makes everything smooth and flawless.” Lindsey echoes Dr. Patel’s sentiment. “The entire staff was wonderful—the nurses and respiratory therapists, along with the lab, pharmacy and radiology departments, took on so much work for these babies and played a crucial role in their care,” she said. “They were so excited for them, and that right there was enough to boost morale in the unit. It was a neat experience for everybody to work together and have something to look forward to.”
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