October 27, 2006

Positivity: Miracle babies in surgery first

Filed under: Positivity — Tom @ 5:55 am

In Brisbane, Australia — a Melbourne couple needed “twin-to-twin” transfusion, only with triplets:

21oct06

THREE tiny unborn girls have been given a chance at life after Australian-first surgery done in the womb of their Melbourne mother.

Geelong couple Nicole and Lawrie Meade’s identical triplets – each less than the size of a tub of butter – would have almost certainly died without the risky operation.

The babies’ 32-year-old mother is still only 19 weeks’ pregnant and survival is a day-to-day proposition for the triplets.

But the Meades, who have a 22-month-old daughter Molly, felt they had no choice but to have the complex surgery.

“There was a slight concern they could die in surgery but all we could see was that, if this could help them survive, we’d do it,” Nicole Meade said.

“If I didn’t have the surgery I probably would have lost them all but now there’s a chance that hopefully they can all survive. We’re still not out of the woods yet but we’ll just take every day as it comes.”

Professor Fung Yee Chan, maternal fetal medicine director at the Mater Mother’s Hospital in Brisbane, operated on the babies in their mother’s uterus in a procedure rarely performed anywhere in the world.

The triplets had a rare condition known as fetal-fetal transfusion syndrome which only affects identical fetuses with a shared placenta connecting blood vessels and umbilical cords.

Instead of receiving nutrients and blood supply equally between the three, one was literally being starved, another was developing reasonably normally and the third was getting more than it should.

A recent scan showed one was 170g, another was 230g and the third about 250g.

Without treatment, just one in 10 babies survives. In a 2 1/2-hour operation, Prof Chan performed keyhole surgery and used a laser to painstakingly seal blood vessels connecting the babies via the placenta.

“You trace each of the blood vessels and find the ones that return to the same baby and leave them alone, and the ones that connect different babies, you seal them,” she explained.

“The technical challenge is not to cut a baby’s own returning vessels.”

Tiny telescopes are inserted into the womb to aid the surgeons.

Prof Chan consulted worldwide medical experts as the operation had never been attempted on identical triplets in Australia.

Nicole and husband Lawrie, 32, flew to Brisbane for the surgery. Their Melbourne specialists referred them to Prof Chan, considered the Australian expert on the condition.

Doctors at the Mater’s Maternal Fetal Medicine Unit have operated on 85 identical twins with the problem, also known as twin-to-twin transfusion syndrome because it mainly affects twins.

They have an 85 per cent success rate of the babies being born alive, one of the best rates in the world.

Even without such a complication, triplets are at increased risk of being born premature, making Prof Chan cautious about the prognosis.

“When they’re identical and share a circulation and you have to operate, it all adds to the risk so it’s only early days,” she said.

“You can never say for sure in medicine, but the chance of them surviving without the surgery was low.

“With the surgery the babies are so far, so good. That’s all I can say.

The Meades (say) ….. “People have said how busy it’d be bringing up four kids under two but compared to the alternative, it’ll be great,” Mr Meade said.

“Bring it on.”

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