UCSD Medical Center has announced the successful launch of its new Fetal Surgery Program, with physicians successfully performing the first Southern California surgery on tiny unborn twin boys for an often fatal condition called Twin-to-Twin Transfusion Syndrome (TTTS).
Father Tino Tinoisamoa with baby Apisaloma in foreground and mother Millie Taulau with baby Mike in UCSD Infant Special Care Center. (To upload printable image see below).
Mike and Apisaloma (Pisa) Taulau were treated with laser surgery for TTTS while still developing inside their mother’s uterus. TTTS occurs in 10-15% of twin fetuses that share the same placenta and, when untreated, has a fatality rate of about 80% for one or both of the babies. The surgery was performed in the 20th week of mother Millie Taulau’s pregnancy. The boys were delivered by cesarean section on September 12, 2005 at 29 weeks gestation and are being cared for at the UCSD Medical Center Infant Special Care Center (ISCC) in Hillcrest.
“We are blessed that the babies are healthy, and grateful for all that the UCSD team has done for us and for the kids,” said Taulau, an Oceanside resident.
In TTTS, abnormal connection of blood vessels in the shared placenta results in an imbalanced flow of blood from one twin to another, affecting circulation. Typically one of the fetuses becomes swollen with too much blood and the other becomes small and underfed because of not receiving enough blood.
When Taulau learned that her developing twins had TTTS, she and the twins’ father Tino Tinoisamoa chose to have the unborn babies treated in utero in an effort to give them both a chance at life.
The parents understood that fetal surgery is a relatively new treatment approach. “We were a little nervous, but we wanted to do anything we could to help our kids,” said Tinoisamoa. “It was an easy choice in the end. We’re glad we could help our babies, and other babies as well who will have now a chance because of this surgery.”
UCSD physician David Schrimmer, M.D., director of the UCSD Fetal Surgery Program, performed the fetoscopic surgery to correct the condition. A very thin telescope called a fetoscope is inserted into the uterus to view the blood vessels, and the misconnected blood vessels are then closed using a laser light, restoring normal circulation. Without intervention, Mike and Pisa would not have survived the pregnancy.
Only six other medical institutions in the United States perform fetal surgery for TTTS. Results are encouraging: In 70% of the cases both twins survive; in an additional 10% of cases, one twin survives. There is a 5% risk of brain damage in babies successfully treated with surgery; which is lower than the rate associated with other TTTS treatments.
ABOUT THE UCSD HIGH RISK PREGNANCY AND DELIVERY PROGRAM:
UCSD Medical Center perinatologists has been providing high risk pregnancy and delivery care to San Diego County residents for over 25 years. Perinatologists are obstetricians/gynecologists with advanced education and experience in high risk pregnancy management who are Board-Certified in Maternal-Fetal Medicine. Utilizing advanced fetal diagnosis and monitoring capabilities, the perinatology team monitors high risk conditions such as genetic anomalies, diabetes, pregnancy in women with pre-existing health conditions, preterm labor and obstetrical emergencies.
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