New surgical procedure helps mum overcome TTTS complication

IPOH: Even though she was only five month’s pregnant, housewife Salmiah Jamaluddin’s belly was so big that she looked as if she was about to give birth anytime.

“When I went for a check-up at the start of this year. I was shocked when I was told my twins had Twin to Twin Transfusion Syndrome (TTTS); that they could die if nothing was done,” related the 39-year-old mother of five from Bagan Serai

TTTS occurs in up to 15% of identical twin pregnancies. It happens when the donor twin transfuses its blood to the other, resulting in one recipient foetus being larger and surrounded by an excessive amount of amniotic fluid due to its increased production of urine.

The donor twin is smaller and appears to be stuck against the uterine wall.

If left untreated, there is up to a 95% chance of either one or both twins dying inside the womb - the foetus who gets more blood may be overloaded with water and die of heart failure; while the other twin is deprived and may die of anaemia.

Luckily for Salmiah, Fetoscopic Laser Surgery for TTTS was just made available in the country at the Raja Permaisuri Bainun Hospital at the time of her diagnosis.

“Fetoscopic laser surgery re­­mained relatively unknown despite being available at the hospital since Dec 2009,” said Perak Health Committee chairman Datuk Dr Mah Hang Soon.

“It is the first facility in the country. Before this, mothers with babies with TTTS had to go all the way to Hong Kong and Australia to seek treatment,” he added.

The hospital’s maternal fetal medicine specialist Dr Japaraj R. Peter said patients were charged RM50 to undergo the procedure compared with RM25,000 in Australia.