TWIN-TO-TWIN TRANSFUSION SYNDROME (TTTS)

Twin-to-twin transfusion syndrom occurs only in those identical twins that are monochorionic-diamniotic (have different amniotic sacs but share the same placenta). The twins share blood through vessels in their common placenta. TTTS occurs when there is an uneven sharing of blood between the two babies.

The smaller twin (donor) does not get enough blood while the larger twin (recipient) becomes overloaded with too much blood. To reduce the blood volume, recipient twin will urinates more and increase the amniotic fluid (polyhydramnios). At the same time, the donor twin will produce less than usual amount of urine and will appear to be stuck against the uterine wall due to very little or lack of amniotic fluid (oligohydramnios).

TTTS occurs in 5-10% of identical pregnancies for reasons that are not clear. It is neither caused by inherited or genetic condition nor caused by anything that the parents has done or not done. If it occurs early in the pregnancy and is left untreated, it is likely to cause loss of both babies.

When TTTS occurs before 26 weeks, the survival rate is less than 10%. Approximately 25% of the surviving fetuses will sustain severe damage of the brain, liver, kidney and other organs. As there is a high risk of losing the entire pregnancy, treatment for TTTS is desirable.

ANEH
Utusan Malaysia - Jumaat, 11 Ogos 2006

Dunia dikejutkan dengan kelahiran bayi-bayi kembar Siam yang bercantum pada pelbagai bahagian badan.

Di Jakarta, Indonesia, seorang ibu melahirkan bayi berkepala dua di sebuah hospital, Isnin lalu. Bayi perempuan itu yang beratnya kira-kira 3.95 kilogram dan 45 sentimeter tinggi diberi nama Syafitri.
Kedua-dua ibu dan bayi berkenaan berada dalam keadaan sihat.

Pegawai-pegawai perubatan percaya Syafitri merupakan bayi pertama lahir dengan dua kepala di negara itu.

English

STRANGE
Utusan Malaysia - Friday, 11th August 2006

The world is shocked with the birth of a twin that is united at all parts of the body.

In Jakarta, Indonesia, a mother gave birth to a two-headed baby in a hospital on Monday. The baby girl that weighed 3.95 kg and 45 cm tall was named Syafitri. Both mother and baby are in a healthy condition.

Medical officers believe that Syafitri is the first baby born with two heads in the country.

CONJOINED TWINS

Conjoined twins are also known as Siamese twins, named after the famous conjoined twins, Eng and Chang Bunker from Siam who were born in 1811. Eng and Chang were joined at the lower chest by a narrow band of flesh through which their livers were connected.

Conjoined twins are monozygotic twins that have not separated completely. Formation of conjoined twins is believed to have be the result of late twinning where the embryo splits more than twelve days after fertilization of the egg. This may due to genetic or environmental factors.

Conjoined twins are very rare and occur in approximately one in every 200,000 live births. The survival rate is between 5% - 25% and most likely to be female, about 70% - 75%.

There are different kinds of conjoined twins, depending on the part of the body where they joined.

• Craniopagus - Joined at the cranium (head or skull).
• Pygopagus - Positioned back-to-back and usually have posterior connection at the rump.
• Thoracopagus - Most common and occurs when the twins are attached at the chest, possibly sharing the heart.
• Cephalopagus - Joined both at head and chest. Rarely survive.
• Parapagus - Twins are attached at the side of the pelvis or stomach.
• Ischiopagus - Twins are attached at the front of the pelvis.
• Omphalopagus - Twins are attached at the abdomen

There are also rare kinds of conjoined twins.

• Parasitic - Assymmetrical conjoined twins, one twin being small, less formed and dependent upon the other.
• Fetus in fetu - Imperfect fetus is contained completely within the body of its sibling.

Conjoined twins separation is highly debated, for both ethical and moral reasons. Separation is often sacrificing one twin to save the other. It also can lead to physical disabilities and permanent brain damage. In addition, there is a possibility the twins will die during the separation.