March 10, 2007

Positivity: Wonder Twins Defy the Odds

Filed under: Positivity — Tom @ 7:01 am

From Australia:

March 06, 2007 12:00am

UNBORN twins given just a one in 10 chance of surviving to birth have been saved by a miracle operation in their mum’s womb.

The successful surgery means it can now be used to save dozens of Victorian babies each year.

Megan Duggan initially was told her identical unborn sons Flynn and Jaxon would almost certainly die when they were diagnosed with twin-to-twin syndrome.

But a team of top surgeons from three hospitals used radical in-utero surgery to save both twins in a Victorian first.

The operation at Monash Medical Centre was undertaken on September 11, but is only now being revealed after both boys were delivered safely in December and have had a chance to develop.

Yesterday Flynn and Jaxon met their lifesavers for the first time.

“It is because of them that the twins are here,” Ms Duggan said of the team. “They’re miracle workers.

“I am just happy to have them. I try not to think that they may not have been here because I have got them and that is all I think about now.”

Twin-to-twin syndrome affects about 42 Victorian pregnancies a year, or 15 per cent of identical twins who share a placenta.

Without surgery, nine out of 10 affected twins die, with one twin getting too much blood for its body while the other starves to death.

Pre-natal surgery to close blood vessels shared by twins increases survival rates of both to 50 per cent, while at least one baby survives in 80 per cent of cases.

The complex procedure has been offered in Sydney and Brisbane since 2001 and was undertaken twice in Melbourne last year before Ms Duggan’s breakthrough operation, which was the first time both Victorian twins survived.

Head of peri-natal surgery at Monash Medical Centre Andrew Edwards said the new Victorian Fetal Therapy Service – a collaboration of the Royal Women’s Hospital, Monash Medical Centre and Mercy Hospital for Women – would attempt to save about 40 threatened babies a year with the procedure.

“Most women know what is at stake,” he said.

“They know how bad outcomes can be and, even when they get one baby, let alone two, it is a big success.

“We have all ended up choosing to work in a high risk area of obstetrics where survival is not guaranteed.

“From our point of view, we see things go wrong fairly often so it is very exciting to see things go well.”

The twins were born after 35 weeks’ gestation at the Royal Women’s Hospital on December 5, before being transferred to Ballarat Base Hospital so Ms Duggan could be close to home.

By placing a telescope fitted with a light, camera and laser through a 3mm hole into Ms Duggan’s uterus, the surgeons identified five “communications of blood vessels” shared by the 325g Jaxon and 439g Flynn.

The laser was then used to seal the vessels so blood from the placenta would be distributed evenly between the boys.

Dr Stephen Cole, from the Royal Women’s Hospital, said the laser procedure also reduced the one-in-five instance of affected children being born with disabilities such as cerebral palsy, blindness and intellectual disabilities,

“The hardest part is working out where to put the telescope to get the right angle . . . to identify all of those vessels.

“Once you have mapped them out the actual lasering is usually pretty straightforward.”

The VFTS collaboration was established with a $642,000 donation from the Pratt Foundation and ongoing support from the State Government.

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