In order to preserve one of a pair of monoamniotic twins, doctors at King Edward Memorial Hospital (KEM) in Pune recently carried out an uncommon and difficult operation. They used lasers to cut off the weaker fetus’s blood supply, which was feeding off the healthier one. To guarantee the survival of the healthier twin, this surgery, performed on September 5, was an essential measure.
At the 21st week of pregnancy, an ultrasound revealed that the mother, a Satara district nurse, was carrying monoamniotic twins. According to the scan, one of the twins had an irregular blood supply and was significantly stunted in growth. Monoamniotic twins, a condition in which both newborns share the same placenta and amniotic sac, pose serious hazards to both foetuses because of the irregular blood flow between them. Blood transfers from one twin to the other in these situations via a vascular link known as anastomosis, which, if left untreated, can cause problems and even death.
In these cases, doctors usually advise ending the pregnancy to prevent damage after birth, particularly if the placenta and sac are shared by both babies. At 23 weeks of gestation, the mother sought professional assistance since she did not want to terminate her first pregnancy. Only three such cases had previously been documented in India, according to Dr. Shweta Gugale, a foetal medicine specialist at KEM, who added that the treatment employed to rescue the healthier twin was uncommon.
There were two steps in the surgical process. The weaker twin’s umbilical chord was first coagulated, so cutting off its blood supply. In order to guarantee that only the healthy twin continued to receive blood, the blood supply cord between the two foetuses was severed using lasers in the second stage. During the delivery of the healthy twin, the weaker twin would naturally contract and be discharged as a membrane.
The medical director of KEM, Dr. Xerxes Coyaji, attested to the extreme rarity and complexity of this treatment. He emphasized the serious dangers, such as the possibility of brain damage or even death for the surviving twin. Although the family and the doctors were aware of these risks, the intervention was required to save the healthy foetus. By October, it was established that the weaker twin had started to shrink while the healthier sibling was growing regularly.
The advancements in foetal medicine and the vital role that specialized therapies play in saving lives in complicated pregnancies are highlighted by this surgical success.
SOURCE :
TIMES OF INDIA
