In-utero surgery performed at Rotunda saves lives of twin girls

SURGERY PERFORMED on foetuses in the womb has been used to save the lives of twin girls in the Rotunda Hospital in Dublin. It was the second such operation performed in Ireland, the hospital said in a statement yesterday.

Lauren and Sophie Greene were born in April, three months after they had been operated on while still in the womb to treat the life-threatening condition, twin-to-twin transfusion syndrome.

The condition occurs when abnormal blood vessels in the placenta within the womb transfuse too much blood into one baby, while the other baby is left with too little blood. If untreated, the condition leads to the death of both babies in almost all cases.

The in-utero surgery, performed by consultant obstetrician Prof Fergal Malone on January 10th last, involved inserting a camera less than one-eighth of an inch thick and other tiny surgical instruments into the womb, identifying the abnormal blood vessels and using laser therapy to fix them.

The twins’ mother, Fidelma Greene (43), from Swords, Dublin, had received the diagnosis of the condition, which affects up to one-quarter of identical twins, 21 weeks into her pregnancy. However, following the surgery, it was possible to bring the pregnancy almost to full term. The twins were delivered by Caesarean section at 34 weeks on April 7th.

Both babies, Lauren weighing 4.58 pounds and Sophie weighing 3.7 pounds, were admitted to the hospital neonatal unit. Lauren was discharged with her mother five days after her birth, while Sophie was kept in hospital for a further nine days. Now, three months later, both are “thriving”, Ms Greene said yesterday.

Advances in in-utero surgery has led to a dramatic increase in the chances of survival for babies with the syndrome, Prof Malone said.

“When one considers that up to recently survival for these babies was so poor, it is gratifying to see the Irish health service investing in new technology that provides such an immediately apparent benefit to our patients.”

The Rotunda performed the country’s first in-utero operation on twin boys diagnosed with twin-to-twin transfusion syndrome in March last year in its newly-equipped foetal operating theatre.

The babies, Ryan and Dylan, were born to Margaret Kershaw (35) from Cork on March 28th last year.

Before that, women whose babies needed operations while still in the womb had to travel abroad, generally to Britain. If the women were unable to travel, their babies often died, the hospital said. The new operating theatre has given women the opportunity to continue their pregnancies in Ireland and has increased the survival chances for babies with life-threatening conditions, Dr Michael Geary, master of the Rotunda, said.

“Doctors at the hospital continue to provide new hope to women whose pregnancies run into life-threatening difficulties as a result of complications,” he said.