NOTE: The following article contains graphic medical imagery. Please read at your own discretion.
When an Ontario mother went into labour 21 weeks and five days early, she and her husband were told there was “no possibility” their newborn twins would survive.
Despite the medical odds of siblings Adiah and Adrial Nadarajah — born 126 days earlier than expected — the teensy twosome survived, becoming the world’s most premature set of twins, as per Guinness World Records.
Adiah was born weighing only 330 grams while her brother weighed 420 grams, making the premature twins a combined 1.65 pounds.
Though a full-term pregnancy is usually 40 weeks, mother Shakina Rajendram began labour before the twins were considered “viable.”
At 21 weeks and five days pregnant, Rajendram said she awoke in the night to “extreme pain,” contractions and bleeding. She and her husband, Kevin Nadarajah, feared they would lose the pregnancy. They travelled to hospital for treatment.
The couple lost their first pregnancy only a few months before the twins were born, making doctors’ warnings about the twins’ fates even more heart-wrenching.
Medical specialists told the hopeful parents they would be unable to assist with such an early pregnancy, as most hospitals do not attempt to resuscitate babies born before the 24-week mark.
“We were in shock. The first thought that ran through my mind was, ‘No, not again,'” Rajendram told Guinness.
Despite doctors’ insistence that there was no hope, ultrasound testing showed the twins still had strong heartbeats and were not in distress.
“We were begging the doctors to do something and save the babies,” Rajendram said. “We felt helpless. We didn’t know what else we could do.”
Though Rajendram had yet to cross the 22-week threshold, the parents were told Mount Sinai Hospital in Toronto had a specialist neonatal intensive care unit (NICU) with available care. When Rajendram’s labour continued into the 21 weeks and six-day mark, Mount Sinai Hospital approved their transfer request.
Even still, doctors at Mount Sinai Hospital told the couple that giving birth before the 22-week mark would be a “death sentence” for the twins. Rajendram said she knew she had to “hold the babies in” until the 22nd week, or the 154th day, of pregnancy.
A half hour before midnight on the 153rd day, Rajendram falsely thought her water broke. She said she cried and apologized to her husband, saying the babies “were going to die because of me.”
After doctors informed Rajendram that her water had not yet broken, she went back to sleep and awoke at 12:15 a.m. the next day when she started to give birth.
The twins received treatment and survived, though the first few months were spent battling for their lives.
After nearly six months, the twins were discharged from hospital and allowed to go home.
“I would say to other parents going through the NICU journey, just being there, being present for your babies, makes a huge difference on the outcomes,” Rajendram told Guinness. “Speak positive words to them. Tell them about how much you love them. Tell them about all of the things you hope, and you dream for them.”
“Be brave to stand up and advocate for what your babies need,” she said.
“We’re amazed that our twins have the record title,” Nadarajah said of the Guinness achievement. “But beyond that, what we’re happy about and passionate about is that this is going to help push the dialogue on viability. We do hope this is a record that gets broken.”
Though Adiah and Adrial Nadarajah hold the record for the most premature set of twins ever born, the most premature baby to ever survive is Richard Scott William Hutchinson of Minnesota. He was born 131 days early and weighed just 11.9 ounces.
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