Twin credible!
How these baby boys were saved by an operation in the womb that their overjoyed parents have hailed as truly...
Kyrie Peters and her husband Craig were overjoyed when they found out they were expecting twins. But their happiness was short-lived when a 20-week scan revealed that their unborn sons had a life-threatening condition – and they were told the only hope of saving them was a pioneering operation that had to be carried out while they were still in the womb.
The boys were diagnosed with twinto-twin transfusion syndrome (TTTS), a condition that affects about 15% of identical twins when they share a placenta and blood supply.
It means one twin gets too much blood, which can put a strain on the heart and lead to heart failure, while the other gets too little, affecting its growth and survival.
Surgeons had to act quickly. They recommended a procedure involving a laser dividing the twins’ shared placenta in two, blocking off malfunctioning blood vessels and restoring an adequate oxygen and nutrient supply.
Kyrie and Craig, faced an agonising choice: if they went ahead with the surgery there was a one in three chance both twins would survive; a one in three chance only one would make it, and a one in three chance they would lose both boys.
Yet if they did nothing, there was a 90% risk their sons would not survive.
‘It was the worst two days of our lives,’ recalls Kyrie, 28. ‘We had gone to hospital that morning for a routine 20-week scan but we could see from the look on people’s faces that something wasn’t right.’
TTTS is a growing challenge for doctors because of the increasing number of twins. In a decade –from 2004 to 2013 – there was a 36% increase in the number of sets of twins born in Ireland. In Britain, since 1984, there was a 71% increase. This is partly due to
rising birth rates, women having children later in life – increasing the likelihood of multiple births – and assisted reproduction technology, such as IVF.
In very mild cases, where the only signs are different levels of amniotic fluid around the two babies, only close monitoring is required. In more complicated cases, treatment involves using a laser to selectively block off blood vessels to stop the blood flow between the two babies.
While this treatment leads to the live birth of at least one twin in 85% of cases, it can leave minuscule blood vessels in place, increasing the risk of the condition returning. The new procedure, known as the Solomon technique, also blocks off any tiny blood vessels which are not visible, but may cause problems after the treatment.
First, an ultrasound is used to identify the ‘vascular equator’ of the placenta – a pattern of blood vessels indicating the dividing line between the individual territories of the twins. A tiny incision is made in the mother’s abdomen, and a guide tube passed into the foetal sac for a laser to cut through the placenta.
Time is of the essence, says Professor Basky Thilaganathan, the consultant obstetrician at St George’s Hospital in London who led the team which operated on Kyrie and her twins.
‘Women tend to be seen within 24 hours and we operate seven days a week. The Solomon technique can be performed in 15 minutes. Comp lication rates are very low and we very rarely need to repeat the procedure,’ he says.
Craig was by Kyrie’s side during the procedure. ‘I saw the tube and camera going in, and could see the twins on the screen – their faces, feet and hands.
‘We then had a six-hour wait for a scan to see whether the fluid levels had balanced out between the twins. Fortunately, they had and we could go home. It was an incredible journey – from desperation to elation in 48 hours.’
Their sons Quinn and Jude, were eventually born three months premature in August 2014, weighing about 2lb each.
The boys, now 19 months old, are healthy and thriving and happy at home in West Sussex. Craig adds: ‘Not a day goes by where we don’t think of the staff at St George’s – and the people who were not as lucky as we have been.’