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Treating
of the Connecting Vessels
Fetoscopic Placental laser Therapy:
Since TTTS does not exist in identical monochorionic (MC)
twins without the connecting placental blood vessels, it seems
reasonable to find a way to separate the twins’ blood
streams by destroying the connections. The availability of
surgical lasers in the early 1980’s led this innovative
option, and the first fetoscopic laser occlusion of the connecting
vessels was performed in 1988 by Dr. Julian E. De Lia at the
University of Utah on a couple from Great Falls, Montana.
By linking the laser to fetoscopy (the insertion of a tiny
telescope into the pregnant uterus), doctors are able to see
and destroy all the connecting vessels. This operation is
the only TTTS treatment that can ‘disconnect’
the twins and stop both the chronic transfusion of blood from
the donor to the recipient, and the acute or sudden transfusion
should one baby pass away or become suddenly ill.
This laser surgery is now performed in centers throughout
the world as more and more doctors are convinced that this
will lead to the best outcomes. To the best of our knowledge,
placental laser surgery results in the highest numbers of
healthy survivors in those patients with previable (i.e.,
less than 25 weeks’ gestation) onset or diagnosis of
TTTS. Reports on this therapy currently indicate the following:
85-90% survival of at least one twin, 70-75% overall twin
survival, 2% or less significant handicap rates in the survivors,
and a treatment to delivery average interval of close to 10
weeks. The results may vary in different centers, and this
may reflect different levels of experience or the actual surgical
techniques used. The procedure involves general anesthesia
for the mother, and the surgical complication rates also vary
in different centers. These must be discussed with the individual
doctors performing the surgery.
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Sophie and
Sara
I underwent the laser surgery on August
14th, 2002, at only 18 1/2 weeks of pregnancy. In the operating
room, Dr. De Lia keeps prayer cards of Saints Gerard and Jude, the
patron Saints of pregnancy and hopeless causes. Just before the
surgery, we said a prayer together and asked St. Gerard to help
our babies stay strong. I drifted off under the anesthesia, knowing
that I was in the hands of a faith-filled surgeon who is totally
dedicated to saving little twin babies with TTTS.
On December 15th, 2002, over eighteen weeks
after their in-utero surgery, our beautiful little angels Sophie
and Sara were born
Katie , Mother of Sophie
of Sara |
