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Houston doctor's surgery could reduce potentially deadly risks for identical twins

It is twin to twin transfusion syndrome or TTTS. It must be caught quickly for the children to survive and there is a doctor in Houston performing a surgery to reverse this complication.

Dr. Kenneth Moise, co-director of The Fetal Center at Children’s Memorial Hermann Hospital and McGovern Medical School at UTHealth, said twins (especially identical twins) are on the rise with an increase in use of invitro fertilization, and identical twins face a risk of not surviving the pregnancy.

“When they share placenta, they share blood vessels across/between them,” Moise said. “And they get out of balance.”

About 15 percent of identical twins share the same placenta and get uneven blood flow from the mother -- one child too little, the other too much. If it's not caught, they won't survive.

Moise performs a delicate surgery to reverse the deadly complication.

“We put a very tiny telescope into the sac of the larger twin,” he said. “We use a laser beam to spot the bad vessels and separate the placenta into two separate circulations so the blood flow stops between the babies.”

Kimberly Rivera was carrying Olivia and Layla when symptoms of TTTS came on last year, in her second trimester.

“I became large really quickly, my uterus grew, I had a lot of abdominal discomfort, a lot of swelling and I honestly thought that was just because I was carrying twins. When I look back at the twin transfusion syndrome, they actually match my symptoms to a tee and had I known that, I would have been better prepared for the diagnosis of the syndrome,” Rivera said.

Moise told her that pain, swelling and discomfort were signs the babies needed this fetal surgery. The promising news is that, he said, in 80-90 percent of cases both babies survive.

“If we don't do the surgery, about 90 percent of the time, we lose the whole pregnancy,” Moise said.

“I couldn't imagine it. I'm an identical twin, I went through life with my twin and so just to have one of them would have been really heartbreaking for us,” Rivera said.

The real take home message is for expectant mothers of identical twins to make sure your doctor is watching carefully for TTTS. Moise said ultrasounds are recommended as frequently as every two weeks for mothers of identical twins.