Pregnant mum who noticed something odd with bump left facing agonising choice
A mum-to-be who noticed something odd about her twin bump was horrified to discover her babies would die without immediate surgery.
Angelina Moffett was given the shocking news after realising her bump felt swollen, hard and "uneven, making me almost hunch over".
She felt "absolutely devastated and terrified" as doctors told her she’d lose both of her unborn sons if they didn’t carry out laser surgery.
But even the operation was an agonising path to take – because there was still a chance she could lose one or both of her beloved boys.
Angelina and her husband Duncan were told the procedure, carried out at St George’s Hospital in London, could trigger preterm labour.
But fortunately, the surgery was a success.
Little Alexander and Harris managed to reach 28 weeks and, despite being born prematurely just five days later, are now adorable tots.
Their parents, from Surrey, have shared their story ahead of World TTTS (Twin-to-Twin Transfusion Syndrome) Awareness Day tomorrow.
They are warning parents of identical twins not to be afraid to challenge the care being given if they suspect the life-threatening condition.
“Don’t be afraid to speak up about the care, especially if it falls below the standards set out by NICE and Tamba," said Duncan, referring to the UK charity, Twins And Multiple Births Association.
"And don’t feel afraid to seek support from other parents who have been through TTTS. We feel very lucky to have received the care that we did."
Angelina was 20 weeks’ pregnant when she was diagnosed with Stage 1 TTTS, which affects the flow of blood from the placenta to each baby.
The condition means one twin – the ‘recipient’ – receives too much blood, with the higher blood volume putting a strain on their heart.
Meanwhile, the other twin – the ‘donor’ – receives too little blood.
This baby often becomes smaller and anaemic – and can suffer from a reduced amount of amniotic fluid, according to Tamba.
The condition is potentially fatal, leaving both babies at risk.
Angelina was monitored and she and Duncan enjoyed some normality – but by 22 weeks, the TTTS was found to have progressed.
It was just hours before this scan, while driving, that the concerned mum-to-be had felt something wrong with her bump.
She recalled: “It felt swollen and hard but also uneven making me almost hunch over which looking back was obviously the result of one of the twins having too much fluid around him.
“My advice to all expectant twin mums is to keep an eye on your bump and get these things checked. We were lucky we had a scan the next morning, if we didn’t it could have been a very different outcome.”
The scan revealed one twin had no visible bladder and was stuck due to having no fluid around him, while the other had an enlarged heart due to the strain of the additional fluid.
The couple were told that without surgery they would lose both boys.
And even after the procedure, they could still lose them.
“I was absolutely devastated and terrified. I felt a failure as a mother because my body wasn’t protecting them like it should,” said Angelina.
“We’d read all the statistics about survival rates and felt so scared and nervous for the future of our unborn children.
“But then reading all the information on the Tamba website really helped us and helped me stay away from the general Internet too much.”
The surgery, carried out by Dr Asma Khalil at St George’s, went well.
However, the worried couple were repeatedly warned that the twin left with a small placenta share may not make it.
They lived in constant fear at each follow-up scan.
Not long after, they celebrated reaching 28 weeks, knowing that one of the twins was now more than 1lb and the chance of survival was increasing day by day.
But just five days later, Alexander and Harris arrived into the world via emergency C-section as Angelina suffered a placenta abruption and lost more than a litre of blood.
The boys were in hospital for 65 days in total.
They came out at what would have been 38 weeks’ gestation.
Duncan said: “We had many ups and downs during our stay including Alex getting very poorly with e-coli and needing ROP surgery, as well as many transfusions and Alex on and off oxygen.
“Our care was split between St Peter’s in Chertsey, which we were lucky is the highest level neonatal intensive care unit in Surrey, and St George’s in London where the surgery took place.
“The best thing St Peter’s did was to know where their knowledge finished and when it was right for us to referred to the specialists at St Georges.
“This was NHS care at its best as consultants at both hospitals were amazing at treating the boys and at ensuring we were both OK and took the time to answer the many questions we both had."
But he claimed: "We know this isn’t always the case which is why Tamba’s research and QI programmes are so important."
What is TTTS?
Twin-to-Twin Transfusion Syndrome (TTTS) is a rare condition that occurs in about 10 to 15 per cent of identical twin pregnancies.
If left untreated, 90 per cent of these babies will die, Tamba says.
And even with treatment, there is only up to a 70 per cent chance of both babies surviving.
Of those that do survive, there is a chance they will suffer from a disability or health condition.
Tamba says: "TTTS occurs when there is an imbalance of blood supply from the placenta to the twin babies.
"One baby receives less blood (the donor) and often becomes smaller and anaemic. They can also suffer from a reduced amount of amniotic fluid and become stuck to the side of the womb.
"The twin who receives more blood (the recipient) becomes bigger and the higher blood volume puts a strain on their heart."
The charity adds: "A common way to help treat TTTS is laser ablation.
"This is where a camera and laser are inserted into the womb and some of the shared blood vessels are coagulated using the laser.
"After this surgery, excess amniotic fluid in the recipient twin’s sac is also removed to achieve a normal volume.
"Only a handful of clinicians across the UK are able to perform laser ablation surgery on twins as it is a highly specialised procedure."
Tamba’s TTTS Registry, set up in 2015, helps specialists learn more about the potentially deadly condition. The charity is raising money to fund "vital" research. To donate to the cause, click here.
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