Monday, November 7, 2011

Twins Pregnancy ......a challenge

I have written about twins in past as well,but there are so many variants of twins and its complicationsit keeps on intriguing me.
Now the latest one is a Lady who had a diamniotic and diachorionic twin (i.e separate Kitchen and separate living room which means separate Placenta and separate sacs),At 12 weeks we discovered that one of the twins has anencephaly i.e absence of front of brain tissue.The other twin is is perfectly alright.Situation would have been worse with monoamniotic monochorionic twins,but thank God for big mercies.Now wondering how to manage her.KCl can be injected in the heart of the abnormal twin which will kill the foetus inside the womb and probably body will absorb it.It has a 5% miscarriage rate.Other option is to manage her without any intervention and then she runs the risk of having increased amniotic fluid around the abnormal baby and thus has 25% risk of Preterm delivery.At the time of delivery this abnormal baby will come live though won't survive for long due to absenceof the brain tissue.
Have again consulted the foetal medicine specialist and they are of the opinion of selective reduction.Will keep you guys posted as we come out of this rather tricky situation. 

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