“My sister and I sat staring at each other in the hospital coffee shop. My abdomen had swollen extensively, and I was in unbearable pain. It was 5.50pm, and a terrifying decision had to be made,” remembers Kristina Madonna from Cape Town. Just under five months into her pregnancy with identical twins, Kristina and husband Sergio found out that their babies were dying. They had just been diagnosed with twin to twin transfusion syndrome (TTTS), a rare condition that affects monozygotic twins who share the same placenta and blood supply. One twin was in heart failure from an oversupply of blood, while the other was not getting enough blood and nutrients to survive.
“Specialist perinatologist Dr Lou Pistorius explained the four options,” Kristina says.which meant choosing which baby was “sicker” and then cutting its cord giving the other twin a chance at life; and, finally, performing foetoscopic laser surgery.” This intricate, high-risk surgery (also called laser ablation) uses laser to separate the babies' “shared” or joint blood vessels in the placenta, effectively rebalancing their blood flow. “But the stakes are extremely high,” Kristina explains. “Our babies were at stage 3 already, where stage 4 means the babies have already passed. Dr Pistorius told us that while he was experienced with the technique, his current success rate of both babies surviving was 25 percent, but that if we could get to London, Prof. Kypros Nicolaides, the pioneer of foetal medicine and this specific surgery, had a success rate of 50 percent survival of both twins, and 75 percent that at least one would make it.”
