Ankura Hospital Doctors Successfully Operate On a Rare Case of Twin Pregnancy Against Odds

Hyderabad: Ankura Hospital, a super specialty Hospital chain dedicated to Women and Children in the state of Telangana & Andhra Pradesh, with 12 Centers at Hyderabad ,Khammam & Tirupati has successfully operated on a rare case of twin pregnancy that survived all odds at its center at Banjara Hills, Hyderabad. 

Sharing the details Dr Durga Prasad ,Medical director, Ankura hospitals said “ A 30-year-old healthy woman in Hyderabad was diagnosed with a very rare form of pregnancy in her 18th week of gestation. She had Monochorionic Monoamniotic twins (two babies sharing the same placenta and amniotic sac in the uterus). Such a case of twins is very rare and occurs in 1 in 35,000 to 1 in 60,000 pregnancies, where serious complications can arise for the foetus. The survival of such foetus occurs in only 50% of cases. In this case, one of the babies had anencephaly (incomplete skull and brain) which made it even more challenging. 

Anencephaly is fatal and at times such a baby in the womb is aborted using special techniques- selective reduction. This procedure can impose a risk of miscarriage and other obstetric complications. We are glad that that we successfully operated on this rarest case not only in the region but also in the country ”.  

“A rare possibility in such a case is expectant management, which is carefully monitoring the pregnancy till term without any such reduction,” says Dr Sarda Vani, the treating Obstetrician from Ankura hospital for women and children. Since expectant management was opted for by the mother-to-be she was offered this special care. This was her second pregnancy and she was healthy with no other medical problem. She was put on bed rest from 20 weeks of gestation onwards. Close monitoring of the health of foetus was done throughout using nonstress testing, measurement of amniotic fluid index, serial growth scans, and umbilical artery doppler studies. These tests monitored the blood flow, growth, and other physiological parameters of the foetus throughout. 

At 33 weeks gestation, an emergency C-section was done for her, due to preterm onset of labour. The twins were delivered successfully. The baby with anencephaly was given compassionate care and could not survive. The other twin, a baby girl weighing 1590 grams cried immediately but developed respiratory distress due to prematurity. She received specialised care in level 3 NICU and could overcome respiratory problems and jaundice with it. With no other medical problems, she was healthy and continued to gain weight, and stayed active in subsequent visits. 

“Prematurity is a major complication in mono amniotic twins as delivery prior to 34 weeks is common in these cases. Careful examination and appropriate investigations are needed for the so called 'normal' twin also as risk of anomalies is higher than normal population in these cases. Provision of appropriate and specialized care in NICU is associated with good neonatal outcome” Said Dr Chanchal kumar, Consultant lead Neonatologist,Ankura Banjara hills.

“Discordance of defects is rare in such pregnancies, and expectant management can help in the survival of healthy foetus without any compilations, as in this case,” adds Dr Sarda Vani,Senior consultant Gynecologist & Obstetrician.

While Monochorionic twins occur in 0.3% of all pregnancies and can pose a challenge in survival and delivery, with a team of obstetricians and neonatologists, and with well-equipped NICUs one can expect successful outcomes.