- Title: USA: In utero laser surgery gives identical twins a fighting chance
- Date: 11th November 2009
- Summary: NEW YORK, NEW YORK, UNITED STATES (NOVEMBER 6, 2009) (REUTERS) TWO DAY OLD PAUL AMBROSO LYING IN INCUBATOR TWO DAY OLD JAMES AMBROSO LYING IN FATHER'S ARMS NURSE ATTENDING PAUL HEART MONITOR SOUNDBITE (English) JAMES AND LINDA AMBROSO, HOLDING BABIES. LINDA SAYING: "Normally one baby would be much bigger and the other baby would be a lot smaller if they even made it." JAMES SAYS: "If either one of them even survived because the surgery saved their lives basically". LINDA SAYS: "We're so excited".
- Embargoed: 26th November 2009 12:00
- Location: Usa
- Country: USA
- Topics: Health,Science / Technology
- Reuters ID: LVAJO6Y8WJ075FXYA34DI4IQSFG
- Story Text: Paul Ambroso is two days old. When he was born, he weighed just 4.3 lbs (1.95 kg). His identical twin brother James was only slightly larger at 4.7 lbs (2.13 kg). Both babies were born healthy although at one point early in the pregnancy, doctors thought they both might die.
The babies were afflicted by a complication called Twin-to-Twin Transfusion Syndrome (TTTS) , a condition that affects about 15 percent of identical twin pregnancies where the twins share a placenta. TTTS occurs when blood flows disproportionately from one child to the other via interconnecting blood vessels. The receiving twin can get too much blood which overloads its cardiac system and causes death from heart failure. The other twin meanwhile, receives too little and may die from severe anemia. Left untreated, nearly all twins affected by TTTS die in the womb.
But not Paul and James. Their mother Linda Ambroso, underwent a new, and minimally invasive laser treatment designed to improve the odds for her twins' survival. If the complication hadn't been detected early, she says the outcome would have been very different.
"Normally one baby would be much bigger and the other baby would be a lot smaller if they even made it." she said. Two days after the twins' birth, Linda and her husband James are counting their blessings.
"The surgery saved their lives basically", said James.
The hour long procedure is performed under local anesthetic, using a scope that carries a laser wire and camera through the mother's abdomen and into her uterus. The surgeon identifies the point at which the recipient twin's umbilical cord joins the placenta then maps every blood vessel emanating from that point.The blood vessels can connect one fetus to the other in different ways, but among the most common is where the vessel of one twin enters the placental wall and re-emerges at another point to connect with the receiving twin. Having identified all the connecting blood vessels, the surgeon applies the laser to coagulate - or spot-weld - the pathways shut. Once completed, the placenta is effectively split into two individual components, each of which services an individual twin. Each fetus can then develop normally.
According to Dr Russell Miller, Director of the Labor and Delivery Unit at the Presbyterian Morgan Stanley Children's Hospital, the risks of laser surgery are minimal compared to the prognosis for TTTS babies.
"There are risks associated with the procedure of either breaking your water, infection, bleeding, pregnancy loss, those are pregnancy specific risks and there are some maternal risks associated with this procedure but again, those risks are believed to be acceptable given that the prognosis of this condition, the severe, early onset twin-twin for both twins is extremely poor", he said.
For the Ambroso family, the outcome was perfect. After two weeks of observation in hospital, James and Paul will join their seven brothers and sisters at home.
Their mother Linda says she can't wait. "We're so excited", she said.
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