BANGALORE: Her joy knew no bounds when she was told in September last year that she was pregnant with twins. But, a few weeks later Jyothi (28, name changed) was jolted when she was told by a gynecologist that one of her twin fetus was growing abnormally and it might also harm her normal child as they were Monochroionic (identical twins growing in placenta) suffering from Twin-to-Twin Transfusion Syndrome (TTTS).
TTTS can happen due to various reasons including genetic defect in case of identical twin pregnancies and if goes undetected can lead to death of even a normal fetus along with the abnormal. This situation is seen in about 30% of Monochroionic twin pregnancy.
Sharing her experience Jyothi says: "Till fifth month of my pregnancy I was not told that one of my children is abnormal. The doctor did not even tell me that treatments like fetal scan are available which can detect TTTS even in 3rd month of pregnancy. Thankfully, I came to know about the technology through Internet and contacted another doctor, who helped me saving my one child."
Explaining Jyothi's dilemma, Dr Prathima Radhakrishnan, consultant, fetal medicine, Manipal Hospitals, said: "TTTS is a complication of disproportionate blood supply, resulting in high morbidity and mortality. Fetoscopic Laser ablation of placental vessels is performed when the condition is severe in monochrionic twin pregnancies. The mortality in this condition without treatment is almost 100%. By performing laser ablaton of the placental vessels, it's possible to save at least one and sometimes both the babies."
Said Dr Devika Gunasheela, senior gynecologist and director, Gunasheela Hospital: "This situation is seen not only in identical twin pregnancies but also sometimes in unidentical twin pregnancies. Also the fetus which gets maximum blood supply is at a risk of dying due to cardiac arrest, while the undernourished twin fetus is at the risk of dying due to malnourishment. Latest laser intervention can help in balancing the blood circulation in the placental and save the fetus."
Dr Radhakrishnan, who has treated 13 women including Jyothi since 2010 said that if the blood supply in the umbilical cord to the abnormal fetus is shut off before its death, the chances for the normal baby's survival is very high and the risk of brain damage is very low.
Jyothi said that India lacks awareness about treatments available for TTTS and other complications during twin pregnancies. "Treatments are available and can save the fetus. We need to create awareness so that not many mothers lose their child," she said.
December 7 is observed as Twin-To-Twin Syndrome Awareness Day globally.
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