KOCHI: Giving a boost to medical advancements, advance treatment for monochorionic pregnancies where twins share same placenta has now come to the state.
According to doctors, monochorionic pregnancies are on the rise these days in the state and in addition to a shared placenta, monochorionic twins have their circulatory systems intermingled in random and have unpredictable anastomoses (reconnection of blood vessels).
This can cause disproportionate blood supply, resulting in twin-to-twin transfusion syndrome (TTTS), say doctors, adding that the chances of late pregnancies turning to be monochorionic are also quite high.
According to Dr Parasuram Gopinath, consultant and scientific director, CIMAR (Centre for Infertility Management & Assisted Reproduction), Kochi, fetoscopic laser photocoagulation is the preferred method of treatment for certain severe cases of TTTS.
“The procedure stops the transfer of blood between fetuses, often halting the progression of TTTS. Thorough evaluation, which may include ultrasound, fetal echocardiogram and amniocentesis, will be conducted before deciding if fetoscopic laser photocoagulation is an appropriate option. Generally, the fetus should be between 16 and 24 weeks of gestation with no other significant anomalies, and the mother should be healthy and have normal cervical length to undergo the treatment,” he said.
Dr Parasuram adds that in monochorionic pregnancies, death of one twin in uterus can cause severe hemodynamic imbalance and intra-uterine death for the healthy co-twin in at least 12 per cent of the cases and around 18 per cent of survivors have neurological disorder.
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