Laser surgery corrects rare disorder in twin foetus
When Surat-based Tabassum Ashraf, 27, started experiencing a rapid increase in her heart beat and pulse rate followed by premature labour pains, she knew all was not well with her pregnancy.mumbai Updated: Dec 08, 2010 01:45 IST
When Surat-based Tabassum Ashraf, 27, started experiencing a rapid increase in her heart beat and pulse rate followed by premature labour pains, she knew all was not well with her pregnancy.
The gynaecologist told Tabassum, then 20-week pregnant with twins, that the foetus were suffering from a rare disorder, Twin-Twin Transfusion Syndrome, that usually leads to a miscarriage. A team of doctors at Jaslok Hospital led by foetal medicine specialist Dr Chander Lulla, performed a laser surgery using a foetoscope to cure the condition. This is the first time that such a surgery has been performed in India.
“There are very few centres in the world that conduct the surgery as it requires expertise and expensive equipment,” Lulla said on Tuesday. The Twin-Twin Transfusion Syndrome affects 10% of pregnancies with identical twins, where both foetus share the same placenta that connects them to the uterine wall for nutrient intake.
In this syndrome, an unequal sharing of blood takes place between the twins leading to one, called the donor twin, becoming small and anaemic with no amniotic fluid around it. The other twin, known as the recipient twin, receives excess blood and faces the risk of cardiac failure. Increased fluid around the recipient twin can also lead to premature labour and due to the lack of fluid around the donor twin, it does not develop a bladder.
Jaslok Hospital doctors inserted a laser beam in the womb using a foetoscope to burn the connection between the two foetus to stop the sharing of blood. The other cure for the condition is to extract the excess amniotic fluid around the recipient foetus. However, that does not help the donor foetus and may cause its death.
“The doctor told me there was one-third chance that the surgery would be successful and an equal chance that I could lose one or both my babies,” said Yunus Ashraf, an insurance professional.
Doctors felt that delaying the surgery could have caused severe complications. On November 23, after Dr Lulla was able to source the foetoscopes from different parts of the country, Tabassum was taken to the operating theatre. Tabassum was under spinal anesthesia and could see the procedure being carried out on a television screen.
The twins are doing well and are constantly being monitored. “Two days after the surgery, amniotic fluid started collecting around the donor baby and its bladder started developing,” said Dr Lulla.