A team of doctors from Jaslok Hospital and foetal medicine specialists from Bangalore performed a path breaking rare surgery of in utero, laser treatment for a complication called twin twin transfusion syndrome (TTTS). This is a path breaking surgery and was performed for the first time in the country and South Asia.
The surgery was performed on Tabassum who was referred to Dr Chander Lulla fetal medicine specialist at the Jaslok Hospital by Dr Deepti Patel, obstetrician from Surat with a monochromic (identical) twin pregnancy at 20 weeks having a complication called TTTS. In this case there was a single placenta being shared by both the twins ie. unequal sharing of the placenta with one foetus (donor) pumping blood into the other foetus (recipient). The donor foetus hence was small, anaemic and had no amniotic fluid around it (stuck twin) with no urine production. The recipient on the other hand because of receiving more blood than it can handle from the donor foetus develops increased fluid around it which can lead to premature labour. There was overproduction of urine and impending cardiac failure due to blood volume overload.
Since the pregnancy was at risk and immediate treatment was required the management at the Jaslok hospital took the decision to treat the patient immediately so that the twins could be saved. The treatment involved disconnection of the shared blood vessels on the surface of the placenta by using laser to burn the vessels within the womb with ultrasonography guidance. The laser fibre is introduced by a special 3 mm fetoscope inserted into the womb. Under vision the connecting vessels are identified and burnt with laser. The twins can then survive independently up to maturity. If the procedure is however not done then there is a high incidence of fetal loss and morbidity.
A team of doctors comprising, Dr Chander Lulla, Dr Sudeshna Ray, and Dr Shradda from Jaslok Hospital Mumbai and Dr Prathima Radhakrishnan and Dr Veena Acharya , fetal medicine specialists from Bangalore came together to save the life of the twins and performed the rare surgery.