New technology assures health for both twins

Medical marvel

In the fifth month of pregnancy, Swati Gupta approached her doctor complaining of breathlessness and tightening of the abdomen. She was known to be carrying identical twins in her womb. 

Her ultrasound showed that one baby was extracting excess of nutrition and blood, leaving serious impairment in the other. 

There was also a discrepancy of 40 per cent in the sizes of the two twins.

One in five identical twins, result of a single fertilised egg splitting into two separate embryos, develop this condition called the Twin-to-Twin Transfusion Syndrome (TTTS). 

It develops because identical twins share a single placenta, an organ through which foetuses get nutrition. Now, a surgery is available in Delhi to treat the complication. 

“We have been performing the surgery since 1991 in Europe. The success rate has increased by nearly 75 per cent in the last 20 years,” said Dr Yves Ville, Professor in Fetal Medicine at the Paris Descartes University, France. 

Gupta was treated with laser ablation whereby the nutrition providing organ was separated for both the twins. They were born weighing 2,000 g and 1,100 g. 

One stayed in the nursery for two days while the other required hospitalisation for 52 days. Three months after their birth, the children are leading a healthy life.  

“The surgery was first done in Apollo Hospital, Delhi in October 2011. Out of the six surgeries performed so far, Gupta is the first one to have delivered the twins,” said Dr  Anita Kaul, senior consultant, foetal medicine, Apollo Hospital. 

One of the cases was unsuccessful, while the others are waiting for successful deliveries.TTTS is diagnosed with ultrasound. It usually appears at 18 to 24 weeks with a difference in the amount of amniotic fluid around the two babies. 

If not treated TTTS can result in miscarriage or death in more than 95 per cent cases of affected twins. 

In survivors, it is associated with complications of poor blood supply and leads to chronic handicap, cerebral palsy in one out of five cases. 

During pregnancy, there is a risk of poor foetal growth, pre-term delivery and single twin demise leading to problems for the surviving twin. There is also a difference in the size or growth of the two twins.

Unfortunately, TTTS cannot be prevented. But laser ablation can treat the condition. It is a foetal surgery (performed while the twins are in womb) in which a laser beam is used to destroy the abnormal vascular connections connecting the two twins. 

The woman’s name has been changed.