(Newswire.net — January 9, 2017) —The mother was in the 29th week of pregnancy when the doctors from the Gynecology-Obstetrics Clinic “Narodni front”, in Belgrade, Serbia, found that one of the twins was pumping blood to the other. As a result, both babies were in critical condition.
“The babies were diagnosed with TAPS syndrome – a Twin Anemia-Polycythemia Sequence, which is a form of a chronic inter-twin transfusion. It happens sometimes when babies share the same placenta in the womb. This state can complicate monochorionic twin pregnancies as one twin is not receiving the appropriate amount of oxygen and nutrients that it needs to develop properly”, Professor and Doctor Dejan Filimonovic explained to MONDO, a Serbian online portal. Dr. Filimonovic is one of the doctors who implemented the innovative intervention that saved the twin babies.
TAPS is a rare disorder that occurs in about 15 percent of identical multiple births. The mortality rate is as high as 80 percent.
“The twin which loses blood is the donor, while the one who receives the blood is the recipient. There are several ways to pump blood. A characteristic common for TAPS is that there must be a small blood vessel which slows down the blood flow. That is why in the end you have one weakened and anemic baby, whereas the other has extremely concentrated blood”, Doctor Filimonovic explained.
He and his colleagues at the hospital in Belgrade fought the TAPS syndrome in a new, innovative way, which has not been applied anywhere in the world.
“In most developed countries, such as America, babies born with only 1.5 pounds, can survive. But it costs money. Thus, in America, for example, doctors treat TAPS after the baby is born, but it requires a different neonatal intensive care and pediatrics, which is better equipped than all of our pediatrics in Serbia all together. This is why we needed to approach the problem differently, while the babies were still in the mother’s womb” the doctor said, adding that the Perinatology in Serbia is at a high level and that doctors provide the same care as their colleagues in more developed countries.
Dr. Filimonovic explained the procedure by starting with the fact that the blood was already there. It was in the system, but simply one baby had more and the other had less. Therefore, the logical solution was to find a way to re-adjust this imbalance. “We decided to take the blood from the twin baby which has more, and to give it to the anemic baby. So far, no one has ever done this, or at least there is no information about it. This procedure requiredserious preparation and a team of 10 experts. It resembled a science fiction movie, with two ultrasonic machines and two needles inserted in two umbilical cords at the same time … My colleague, professor Željko Mikovic, drew the blood, then our transfusion service team slipped it through the filter, added anticoagulants, and then we gave this treated blood to the anemic baby.”
Anticoagulants had to be added because when the blood does not go through the bloodstream, but rather through a system of filters, there is a possibility of blood clotting
And that is how the Serbian doctors “bought” two precious weeks for the twin babies in their mother’s belly.
“It’s not a problem to give the baby blood while it is still in the womb. We have been successfully doing this for the past 15 years. In this case, we also could do an intrauterine transfusion, but then we would have a bigger problem – the baby who gives its blood to the other would still remain without it, and the other would have too much. That’s why we pulled out the blood that is already in the bloodstream of the baby which had a surplus of it”, said Dr. Filimonovic, reminding that every additional day spent the mother’s womb is beneficial for the baby.
When the pregnancy reached 32 weeks, the doctors performed a Caesarean section, and the two babies were born. One was still anemic as expected, and the Neonatal Intensive Care Unit at the Gynecology-Obstetrics Clinic “Narodni front” in Belgrade was equipped to provide the babies with the care that they need.
The babies were born with a weight of about 2.4 and 2.5 pounds, but the doctors have succeeded in what they considered was most important – they extended the babies stay in their mom’s belly until they reached the necessary gestational maturity.
The tiny heroes of this story are now healthy, at home, and growing at full strength, without any consequences of the TAPS syndrome.