A Scottish mother has told of her joy after doctors saved the lives of twins affected by a rare condition by performing intricate laser surgery while they were inside her womb.
Deborah Johnston, from Glasgow, was six months pregnant with identical twins Theo and Olly when she was diagnosed with life-threatening twin-to-twin transfusion syndrome (TTTS).
It affects identical twins who share the same placenta, meaning they also share the same blood supply, and it occurs randomly when there is an imbalance in the blood exchange between them.
One twin, the donor, loses more blood than he or she receives and risks malnourishment and organ failure while the recipient twin receives too much blood and can suffer cardiac and other complications.
If she did nothing, Johnston was told she would probably lose both twins, while draining fluid might only have helped one sibling. Meanwhile, undergoing surgery, known as endoscopic laser ablation, would give both babies a roughly one in three chance of survival.
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Under the procedure, a laser beam is used to seal off some of the blood vessels in the placenta so that both babies receive a more equal supply of blood. After the laser surgery, excess amniotic fluid is removed.
Johnston, 42, felt surgery was the only option, but feared history repeating itself. Remarkably, both her parents had lost a twin sibling at birth. Also, because she was more than 26 weeks pregnant, surgery would be complicated by the thickness of the blood vessels.
She said: “We were told about the condition at the first appointment with the consultant, but you hope and pray it won’t happen to you. Then, at one of my scans, it became clear there was lots of fluid surrounding one twin and not as much around the other.”
Johnston was being scanned twice a week, but woke one morning in such discomfort she could barely move. A scan at Wishaw general hospital indicated an abnormal reduction in amniotic fluid around one twin caused by a loss of blood volume to his brother.
Johnston was immediately referred to the Queen Elizabeth hospital in Glasgow where a specialist informed her that both twins were very poorly and offered her the three options.
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She said: “I was devastated but laser surgery seemed the only option as it gave us hope. I was shocked that there was only a 33 per cent chance both our boys would make it because they were so poorly, but we clung on to that hope.
“Both my mum and my dad lost their twin at birth, and it was in the back of my mind that it could happen again. The next day we heard two heartbeats and the relief was incredible.”
Johnston was able to go to full term, giving birth to Theo (4lb 6oz) and Olly (4lb 7oz) via a planned Caesarean section last year. The brothers spent four days in neonatal care and then special care for a further ten days before being allowed home in time for Christmas.
Johnston, who spoke out to help mark World TTTS Awareness day last week, said: “They were tiny, but they were perfect. Taking them home in time for Christmas was the best present ever.”
