Speaker 1: You're listening to a Mama Mia podcast.
Speaker 2: Mamma Mia acknowledges the traditional owners of land and waters
Speaker 2: that this podcast is recorded on. We pay our respects
Speaker 2: to elders past, present and emerging, and feel privileged to
Speaker 2: continue the sharing of birth stories and knowledge that has
Speaker 2: been a fundamental part of Indigenous culture. Hi.
Speaker 3: I'm Cassanya Lukich and this is diary of a birth.
Speaker 3: When Marnie Cochrane fell pregnant through IVF at forty two,
Speaker 3: she thought the hardest part of her fertility journey was
Speaker 3: behind her. But she was in for a big surprise.
Speaker 3: Her single embryo transfer turned into identical twin girls. Then
Speaker 3: a routine scan at twenty two weeks revealed a complication
Speaker 3: that would change everything.
Speaker 4: Everything had been fine prior with the scans in between
Speaker 4: thirteen and twenty two weeks. And when I walked in
Speaker 4: that day to the hospital, you know that were scanning
Speaker 4: me and everything seemed normal. At the end of the scan,
Speaker 4: they said, oh, look, we're just going to bring in
Speaker 4: a doctor, and you know, we waited for what seemed
Speaker 4: like forever.
Speaker 3: In today's episode, Marnei shares her extraordinary story of navigating
Speaker 3: one of the rarest twin complications taps, where one twin
Speaker 3: becomes dangerously anemic while the other develops too many red
Speaker 3: blood cells.
Speaker 1: So let's meet today's marm.
Speaker 4: My name's Many and this is the diary of my
Speaker 4: birth with my twins, Billy and Poppy.
Speaker 3: You know, your journey to getting pregnant obviously took a
Speaker 3: little bit of time. But what was your life like
Speaker 3: before you fell pregnant with the twins.
Speaker 4: I have been with my husband for a really long time,
Speaker 4: so we had been together, I think for about six
Speaker 4: years before we settled on the Gold Coast and bought
Speaker 4: our first townhouse together, and we had plan to get
Speaker 4: pregnant pretty soon.
Speaker 5: And yeah, it.
Speaker 4: Took obviously many years, but in that time, I guess
Speaker 4: we just spent a lot of time together.
Speaker 5: He's fantastic.
Speaker 4: We have adopted five birds, and we eventually upgraded to
Speaker 4: a bigger house on the Gold Coast. We hoped for
Speaker 4: a child and for the birds as well, so somewhere
Speaker 4: a little bit bigger that would house the birds and
Speaker 4: us and hopefully a child.
Speaker 1: Yeah, when you got pregnant, you went through IVF. They
Speaker 1: just put one embryo in and lo and behold.
Speaker 4: Yes, Well we didn't actually find that out until about
Speaker 4: thirteen weeks. So the IVF journey I was so nervous
Speaker 4: about that. I really was quite reluctant to do it.
Speaker 4: But we needed it obviously as I got older. But
Speaker 4: we had a bit of a triple whammy. So my
Speaker 4: age was against me. I had suspected endo and also
Speaker 4: my husband has a male fertility issue as well.
Speaker 5: Like everything was against us.
Speaker 4: And yeah, so we found a newer specialist and it
Speaker 4: went like a dream, like they got more eggs than
Speaker 4: they thought they would get.
Speaker 5: They told me maybe three, like zero to three. We
Speaker 5: got five.
Speaker 4: I think they expected maybe one to fertilize out of those,
Speaker 4: and we got three embryos out of that, and then
Speaker 4: they implanted one and at first we thought it was
Speaker 4: just one child. So I'd had a couple of scans
Speaker 4: at seven weeks and then at eleven weeks and the
Speaker 4: child was developing quite nicely. But yeah, we found out
Speaker 4: at thirteen weeks that that embryo had actually split and
Speaker 4: we were pregnant with identical twins.
Speaker 1: Was it that the embryo split quite late in the process.
Speaker 1: Is that why they wouldn't see it? Or was baby
Speaker 1: be hiding.
Speaker 4: So the first couple of scans I had wasn't like
Speaker 4: a professional ultrasound place. It was with my utility specialist,
Speaker 4: which is what they usually do just in the early weeks,
Speaker 4: just to make sure that there's a heartbeat and that
Speaker 4: you know, you go along and you do your.
Speaker 5: Nipped test and stuff like that.
Speaker 4: So they were really quite quick, and I think she
Speaker 4: was just looking for a baby and a heartbeat and
Speaker 4: didn't go looking for that second because we had one
Speaker 4: embryo implanted. I was forty two. It was amazing that
Speaker 4: I got pregnant first round at my age with one embryo.
Speaker 4: So yeah, I just don't think she went looking for it.
Speaker 1: So your partner, Lee and you, when you find out
Speaker 1: you're having twins, what was your reaction?
Speaker 4: Well, if I'm going to be really honest, the first
Speaker 4: reaction was an internal screaming no. I guess A few
Speaker 4: thoughts run through my mind. One was, oh my god,
Speaker 4: how am I going to cope with twins? My finances
Speaker 4: went through my head. Complications because I knew, like, we
Speaker 4: did everything that they told us to do during the round,
Speaker 4: so I knew that were identical twins, and so I
Speaker 4: was scared for the risks, you know, to me to
Speaker 4: the babies.
Speaker 5: So yeah, I was immediately.
Speaker 4: Fearful, but it's interesting what you do in that moment,
Speaker 4: like lower scanning the one. All I wanted to find
Speaker 4: out was if the other one was healthy. So I
Speaker 4: just had that instinct to protect them and that they
Speaker 4: were my babies, like immediately, even though I was like,
Speaker 4: oh crap, what am I going to do? So but
Speaker 4: once we started telling family members and workmates, you know,
Speaker 4: that fear turned into excitement and we were just like,
Speaker 4: oh my god, they're going to have a best friend
Speaker 4: for life.
Speaker 1: How cool is that? And a connection for life?
Speaker 4: Absolutely yeah, And we'll never understand this. We'll never understand
Speaker 4: this bond, but they will have it, and it was
Speaker 4: just incredible.
Speaker 1: Unfortunately, at twenty two weeks you did find out that
Speaker 1: there was a complication. Will you run us through that?
Speaker 6: Sure?
Speaker 4: So, because we found out quite late in the piece
Speaker 4: that I was having twins and that they were identical
Speaker 4: and that they shared a placenta, my referral to the
Speaker 4: hospital was, I guess a.
Speaker 5: Little bit later than normal.
Speaker 4: So at twenty two weeks I walked into my maternal
Speaker 4: fetal medicine scan. Everything had been fine prior with the
Speaker 4: scans in between thirteen and twenty two weeks. And when
Speaker 4: I walked in that day to the hospital, you know,
Speaker 4: they were scanning me and everything seemed normal. And then
Speaker 4: at the end of the scan, they said, oh, look,
Speaker 4: we're just going to bring in the doctor. And you know,
Speaker 4: we waited for what seemed like forever, and I've just
Speaker 4: had no thought in my mind that anything was wrong,
Speaker 4: even though I'd read the paperwork and the recommendations and
Speaker 4: things like that. And yeah, they told us that they
Speaker 4: suspected that the girls had twin anemia polypcythemia sequence or TAPS.
Speaker 1: So basically, one baby was anemic and one baby had
Speaker 1: too much by.
Speaker 5: Red blood cells.
Speaker 4: Yeah, exactly, Yeah, Yeah, so yeah, bloodtoothin, blood tooth thick
Speaker 4: they say, like lemonade and tomato sauce.
Speaker 5: That's the kind of consistency of the blood.
Speaker 1: Yeah, And what's the treatment for that? How do they
Speaker 1: help you get to term?
Speaker 4: Yeah, it's a really difficult thing because one TAPS is
Speaker 4: really quite newly discovered, like only in the last eighteen
Speaker 4: years or so, so the best treatment still hasn't been
Speaker 4: found out. So what they do is really individual to
Speaker 4: each person. In our case, there were options that were
Speaker 4: available to me and options that weren't. So in some cases,
Speaker 4: they can do laser surgery to laser the tiny connections
Speaker 4: in the BLAS center, doing in uterotransfusion, they can birth
Speaker 4: the babies early, or they can just wait and see,
Speaker 4: depending on that. So I had a bit of a combination.
Speaker 4: They wanted to wait and see how the girls went
Speaker 4: because in some cases they can adapt to their new
Speaker 4: I guess environment in the womb. But it did progress
Speaker 4: and did get worse, and that's where we had to
Speaker 4: look to treatment.
Speaker 3: Yeah, so, as I understand it, you had a blood transfusion.
Speaker 1: Yes, how does that work in utero? Yeah?
Speaker 4: Sure, So this is very interesting, especially when it comes
Speaker 4: to twins. So an in uterotransfusion for a normal anemic
Speaker 4: singleton baby is quite common, but in twins it's really uncommon.
Speaker 4: So what they actually had to do was transfuse adult
Speaker 4: donor blood to my anemic baby and take out small
Speaker 4: amounts of blood out of the polycyphemic baby and replace
Speaker 4: that with warm saline. So it was a very scary
Speaker 4: procedure and the way they do it. So I had
Speaker 4: an anterior placenta. It was right in front, so easy
Speaker 4: access to the placenta and umbilical cords. And they go
Speaker 4: in with a big needle, one by one and they
Speaker 4: go into the placenta and then the umbilical cord and
Speaker 4: they that's when they transfuse the blood. And then obviously
Speaker 4: they go into the next baby, big needle through the
Speaker 4: plazender and the umbilical cord and take out small amounts
Speaker 4: of blood and replace that with warm, salty water.
Speaker 1: And were you awake for this procedure?
Speaker 5: Yeah, so the first.
Speaker 4: One at twenty eight weeks, that one was actually just
Speaker 4: done in an ultrasound room. They set up a sterile
Speaker 4: environment and they actually have blood testing on site, so
Speaker 4: there's a formula attached to it as well. They find
Speaker 4: out how much blood they need and the doctors calculate
Speaker 4: all that. But yeah, I was awake, felt everything. There's
Speaker 4: only a local anesthetic on your belly, yep, just to
Speaker 4: numb where the injection site or the needles go in.
Speaker 4: And I had like a little bit of medication to
Speaker 4: I guess keep me calm, and medications to stop the
Speaker 4: uterus contracting and things like that.
Speaker 5: But I could see and feel everything.
Speaker 4: So they had the ultrasound screen up so I could see,
Speaker 4: you know, I just wanted to check that the baby
Speaker 4: girls were still moving and hearts were still beating and
Speaker 4: things like that.
Speaker 5: And Lee happened to be there with me during that one.
Speaker 4: I mean, it was very scary and surreal just to
Speaker 4: think about it, Like when I think about myself in
Speaker 4: that ultrasound chair looking at the screen. Yeah, it's just
Speaker 4: it's amazing what they can do. A bit at the
Speaker 4: same time, you're thinking, oh my god, is this my life?
Speaker 1: So yeah, I mean it's one thing to be pregnant
Speaker 1: after you know, years of infertility. It's enough to be
Speaker 1: pregnant with twins, and it's another thing on top of
Speaker 1: that when there's complications. Definitely, So in terms.
Speaker 3: Of like your mental health and how you were coping.
Speaker 1: Yeah, how was that time for you?
Speaker 5: Yeah? It was very hard.
Speaker 4: I mean, the thought of having something wrong with your
Speaker 4: babies in utero. Like I think the first thing I
Speaker 4: went to was, you know, what did I do? You know, like,
Speaker 4: this must be my fault. It must be something I ate,
Speaker 4: something I did in my you know, like pre pregnant life.
Speaker 4: You know, you think of all the things things and
Speaker 4: mum guilt sets in really quickly, But really I just
Speaker 4: had to turn to the focus of putting my trust
Speaker 4: in the doctors. We have such an incredible medical system,
Speaker 4: especially in Queensland, and access to the brilliant doctors at
Speaker 4: Martyr Hospital in Brisbane. It's incredible, Like the doctors up
Speaker 4: there are just world class and what they do is
Speaker 4: just unbelievable. So I did really feel like I was
Speaker 4: in good hands. I just had to trust that, yeah,
Speaker 4: that we would be okay. It was definitely hard. There
Speaker 4: were a lot of tears and I just had to
Speaker 4: lean on my supports.
Speaker 5: Like I had to.
Speaker 4: Like, there weren't many people going through what I was
Speaker 4: going through.
Speaker 5: It's so rare.
Speaker 4: It only happens in like three to five percent of
Speaker 4: identical twin pregnancies, so yeah, it's it's extremely rare. There's
Speaker 4: not a lot of people you can reach out to.
Speaker 4: But like I had my family and then I also
Speaker 4: had a tach support for them who were just wonderful.
Speaker 4: So yeah, sought some help online as well. You know
Speaker 4: what questions to ask and you know what's it like
Speaker 4: and can anyone tell me if they've had any UTEROI
Speaker 4: transfusion before, so really just reaching out to all the
Speaker 4: resources I could to help get me by.
Speaker 5: It was just really like survival mode, to be honest.
Speaker 3: I imagine that there was a discussion of how far
Speaker 3: into the pregnancy they would like you to get, and
Speaker 3: I imagine that they were suggesting.
Speaker 1: A c section because you were higher risk.
Speaker 3: Did they have a goal for you and can you
Speaker 3: tell us a little bit about going into labor?
Speaker 1: Sure?
Speaker 4: So, yes, the goal, and in most cases with taps
Speaker 4: is thirty two weeks. Getting to thirty two weeks usually
Speaker 4: the placenta is not happy by the end of thirty
Speaker 4: two weeks and it's a good idea to birth them
Speaker 4: because it gets riskier. There's no more treatment that can
Speaker 4: be done at that stage. So the aim for me
Speaker 4: was to get to thirty two weeks. Unfortunately, at thirty
Speaker 4: two weeks I went to my local hospital. They didn't
Speaker 4: have any nick Cure special care beds available for the girls,
Speaker 4: so they turned me back around, referred me back to
Speaker 4: the martyr and said, let's see what they think they
Speaker 4: should do with you, and they suggested another transfusion, which
Speaker 4: we did at thirty two weeks.
Speaker 5: Very very risky, but this time.
Speaker 4: It was in theater with an epidural, so I felt
Speaker 4: a lot safer if something went wrong, they could just
Speaker 4: birth the girls. Thankfully, it was very successful and they
Speaker 4: sent me home the next morning and just said it
Speaker 4: could be any time. If we get a couple of
Speaker 4: days out of this, it'll be great, And I was like,
Speaker 4: oh wow, Like reality just really set in. Then I
Speaker 4: got to thirty three plus two and my waters broke.
Speaker 4: So sitting on the couch on a Saturday night and
Speaker 4: my waters broke and I went to hospital.
Speaker 5: Now, my local hospital still.
Speaker 4: Didn't have nick cure or special care beds, so I
Speaker 4: stayed a couple of days there with antibiotics and there
Speaker 4: was no labor progressing aside from the water's breaking.
Speaker 5: So they sent me up to Marta and.
Speaker 4: When I got there, we made it through one night.
Speaker 4: The aim was to get me to thirty four weeks,
Speaker 4: so that was the plan. I was like, we had
Speaker 4: it in our minds Oka thirty four weeks, I was
Speaker 4: thirty three plus six and I went for a well
Speaker 4: being scan and everything seemed fine. That was at four
Speaker 4: o'clock in the afternoon. At ten pm during a routine CTG,
Speaker 4: my baby be had a very high heart rate.
Speaker 5: So they were like all of.
Speaker 4: A sudden, doctors and nurses swarming around me and said
Speaker 4: it's time to get the girls out. So my husband
Speaker 4: was still at home an hour away and didn't quite
Speaker 4: make the birth.
Speaker 5: Oh no, yeah.
Speaker 4: I asked them to hold on, like cut, you just
Speaker 4: hold on an hour until he gets here, but expecting
Speaker 4: to birth the next day. He rushed up the motorway
Speaker 4: but still didn't quite make it. But I found out
Speaker 4: later that it was probably like a category one sea section.
Speaker 4: They were like, these babies have to come now. It's
Speaker 4: really bad, but I didn't realize like they made me
Speaker 4: feel like, yes, it's an emergency, but everything's going to
Speaker 4: be okay.
Speaker 1: Coming up.
Speaker 4: My husband arrived just as Poppy had been born, so
Speaker 4: Billy was born first and she was the one whose
Speaker 4: heart rate had caused the emergency sea section.
Speaker 1: So by yourself, were you scared?
Speaker 5: Absolutely?
Speaker 4: I burst into tears a minute that they told me
Speaker 4: that the babies had to come right that minute. I
Speaker 4: was frantic, like calling my husband. I just I couldn't breathe.
Speaker 4: It was really awful. At one point when we got
Speaker 4: when I got to theater and I had everyone around me,
Speaker 4: and they asked you all the questions, what are we
Speaker 4: doing today having a C section? I started to calm
Speaker 4: down once I saw my medical team and I asked, someone,
Speaker 4: can you put on my playlist? Because I had organized
Speaker 4: a playlist and it was all my favorite songs. Forty
Speaker 4: five minutes of my favorite songs. They said, yep, we
Speaker 4: can absolutely do that. I was like, oh my god,
Speaker 4: thank you so much, started crying again, and then one
Speaker 4: of them put their hand on my shoulder and went, okay,
Speaker 4: let's have a birthday party. And that's where I was like, Okay,
Speaker 4: I feel well looked after now. So even though I
Speaker 4: didn't have my husband, I had my music, I had
Speaker 4: an incredible medical team, and I just really had to
Speaker 4: be grateful for what I.
Speaker 5: Did have, not what I didn't have.
Speaker 4: So yeah, yeah, and I knew that the babies were
Speaker 4: going to be safe as well.
Speaker 1: So the babies come out, did they go straight to
Speaker 1: the niku?
Speaker 5: Yeah, So they showed the girls to me.
Speaker 4: Their cards had to be cut straight away and they
Speaker 4: were whisked away. My husband arrived just as Poppy had
Speaker 4: been born, So Billy was born first, and she was
Speaker 4: the one whose heart rate had caused the emergency C section,
Speaker 4: so she was born first, and then Poppy was born
Speaker 4: and Lee just arrived, so he was able to follow
Speaker 4: them up, which was amazing.
Speaker 1: Yeah that's good. That would have made you feel a
Speaker 1: little bit calmer.
Speaker 5: Yeah. Yeah.
Speaker 4: All I could like at that point was about the babies,
Speaker 4: and so he was like, do you mind if I
Speaker 4: go up and I was like, yes, please go, yeah, go,
Speaker 4: and he named them up there and everything.
Speaker 1: So, yeah, tell me about your first time holding them. Yeah.
Speaker 4: So I actually didn't get to hold them what was
Speaker 4: one by one at first? They were in the nicku
Speaker 4: in separate CODs at separate ends of the room because
Speaker 4: that's all they had at the time. Yeah, it was
Speaker 4: a little bit sad, but I mean, the facilities up
Speaker 4: there are just so wonderful and the nurses are incredible.
Speaker 4: So I didn't get to hold them until about twelve
Speaker 4: hours after the birth, and that was separately, and it
Speaker 4: was all about of a whirlwind. I think I was
Speaker 4: a little bit drugged up still, to be honest, and
Speaker 4: I just couldn't believe everything that happened.
Speaker 5: I was just I think I was just in shock.
Speaker 4: But I do remember the moment that I held them
Speaker 4: both together, which was a couple of days later, and
Speaker 4: that was just the best thing ever, Like they were
Speaker 4: finally safe, they were finally together, they were finally with me,
Speaker 4: And yeah, it was just a beautiful, beautiful moment just
Speaker 4: holding them.
Speaker 1: Yeah. Well, you had, you know, months and months of
Speaker 1: stress and anxiety and stressful birth. To have them safe
Speaker 1: would have just been so special.
Speaker 5: Absolutely, Yeah, it was just wonderful. Yeah.
Speaker 3: And the question that I'm sure everybody asks a twin mom,
Speaker 3: did you mix them up?
Speaker 5: No?
Speaker 4: So well, I guess from the beginning. So we actually
Speaker 4: discovered that the reason that Billy caused the emergency c
Speaker 4: section was because I got an infection after the waters broke.
Speaker 4: So I ended up getting an ecoli infection on my
Speaker 4: placenta which spread to Billy because only her amniotic sac broke.
Speaker 4: So it was really easy to tell them apart because
Speaker 4: she had a line with antibiotics. So I know that
Speaker 4: sounds it's quite sad, but at the same time that
Speaker 4: it was impossible to mix them up, so we definitely
Speaker 4: knew who was who. But even after we got home,
Speaker 4: I never mixed them up.
Speaker 5: I just knew who was who.
Speaker 4: And I think the way that I answer that because
Speaker 4: everyone says, oh my god, they look exactly the same.
Speaker 4: I just say, I'm their mum and I can tell.
Speaker 4: So they're so different in personality, even their laughs, their voices,
Speaker 4: They've got opposite sides, like hair worlds.
Speaker 5: Yeah, they're just so different to us.
Speaker 1: How old are they now?
Speaker 5: They're two years old. Yeah, they just turned too.
Speaker 1: Yeah, and how was your recovery?
Speaker 5: Yeah it was rocky.
Speaker 4: My pain was definitely not controlled in the first few days.
Speaker 5: Yeah, my pain level was just through the roof.
Speaker 4: And the way they explained that is sometimes because of
Speaker 4: the extra stretching and things with twins, the pain level
Speaker 4: can be higher, so it was really hard to get
Speaker 4: that under control. So yeah, definitely for the first couple
Speaker 4: of weeks, I actually had to go home with pain relief,
Speaker 4: which is apparently not that common, so I need an
Speaker 4: extra extra week with the painkillers. But after that it
Speaker 4: was it was fairly okay, I think.
Speaker 1: Yeah, yeah, well you were sleep deprived and looking up
Speaker 1: through newborns.
Speaker 5: Yeah, I barely remember that.
Speaker 4: So, yeah, pumping eight times a day and you know,
Speaker 4: feeding eight times a day, and yeah, sterilizing and trying
Speaker 4: to get maybe an hour and a half combined sleep was. Yeah,
Speaker 4: it was definitely a whirlwind, and you kind of forget
Speaker 4: your own needs when you're going through all that, and
Speaker 4: certainly with twins in nick you and special care as well,
Speaker 4: you're you know, coming back and forth for feeds and
Speaker 4: doing as much as you can while they're in hospital.
Speaker 1: Yeah. Well, thank you Mony so much for sharing your story.
Speaker 1: It's really remarkable and I'm really glad that the twins
Speaker 1: and you are okay. And how are they today? Are
Speaker 1: they wild?
Speaker 5: Yeah, they're amazing.
Speaker 4: So they've just been so determined since the beginning, and
Speaker 4: it's really blown me away.
Speaker 5: How robust and strong they are.
Speaker 4: They're still a little short and little, i'd say for
Speaker 4: two year olds, but they've been so active since the beginning.
Speaker 4: They walked, you know, twelve months. They're talking a lot,
Speaker 4: they love reading books, they're just they love climbing over things.
Speaker 5: Yeah, I guess they're just normal two year olds.
Speaker 4: And to be honest, we're quite scared of, you know,
Speaker 4: what would happen with all the complications and how delayed
Speaker 4: they might be, because that's a very real possibility with
Speaker 4: twins with taps. And I think it's really like testament
Speaker 4: to the treatment that we had and the treatment that
Speaker 4: was available to us that it really helped them, especially
Speaker 4: you know now with their development as well.
Speaker 5: So yeah, I'm just so thankful.
Speaker 4: To the doctors for getting us where we are today,
Speaker 4: and they're just lovely little girls.
Speaker 3: Because TABS is such a rare condition, I wanted to
Speaker 3: ask our resident ob and gynecologist, doctor Bromin Devine about
Speaker 3: how likely it is to come across it.
Speaker 6: In Australia, we see monocoreonic twins in about one in
Speaker 6: four hundred berths. It is more likely if you get
Speaker 6: monocoreonic identical twins where the embryo splits, but they share
Speaker 6: a placenter with IVF pregnancies, and that's probably because of
Speaker 6: the way that we manipulate the embryos a little bit
Speaker 6: in the lab or the media that we use. But
Speaker 6: TABS or twin anemia polypcythemia sequence occurs in about three
Speaker 6: to fifteen percent of monocoreonic twin pregnancies or MCDA twin
Speaker 6: pregnancies that we see in Australia. Now, there's two reasons
Speaker 6: that it can occur. Sometimes it's spontaneous and other times
Speaker 6: it's because we do laser therapy. So when there's a
Speaker 6: shared placenta, there are blood vessels that communicate between the
Speaker 6: two twins because they've got one placenta between the two
Speaker 6: of them. Sometimes, if there's a big blood vessel that's
Speaker 6: connecting them, the twins can have major shifts in their
Speaker 6: amniotic fluid and they can become very sick with the
Speaker 6: condition that we've talked about before called twin twin transfusion.
Speaker 6: One of the ways of treating twin twin transfusion is
Speaker 6: to use laser therapy to disrupt that connecting blood vessel,
Speaker 6: and one of the things that can happen as a
Speaker 6: result of that is you can get little partial connections
Speaker 6: or what we call partial anastemosis in the placenta, where
Speaker 6: you get a little connection between an artery and a vein,
Speaker 6: and that leads to one twin giving all their blood
Speaker 6: cells to the other twin. So that twin that gives
Speaker 6: the blood cells is called the donor, and it gets
Speaker 6: a very low quantity of red blood cells and become anemic,
Speaker 6: and the other twin, which is the recipient, gets a
Speaker 6: much increased number of red blood cells, and that's a
Speaker 6: condition called polycythemia, or that twin becomes polycythemic. Now it's
Speaker 6: bad to be anemic and it's bad to be polycythemic.
Speaker 6: So the poor little anemic twin doesn't grow, doesn't get
Speaker 6: anywhere near as much oxygen or nutrients, and the other
Speaker 6: twin can get really overloaded with a really sluggish blood
Speaker 6: flow and get clots in blood vessels and things like that,
Speaker 6: so it's dangerous for both twins. Interview. Turine transdusion is
Speaker 6: one of the forms of treatment, or a partial exchange transdusion,
Speaker 6: one of the forms of treatment that they do for
Speaker 6: this condition. That's done by very specialist obstetricians known as
Speaker 6: maternal fetal medicine specialists, and it's usually done at a
Speaker 6: maternal feedal medicine clinic in one of the big tertiary hospitals.
Speaker 6: They have specialist obstetricians who've done additional training in really
Speaker 6: high risk pregnancies. And the other thing we do is
Speaker 6: we monitor these twins very carefully by keeping a very
Speaker 6: close eye on the blood flow in the brain because
Speaker 6: we can see the sluggish blood flow to the polycythemic
Speaker 6: twin and quite a rapid blood flow to the donor twin.
Speaker 6: By checking on the blood flows using ultrasounds, so there's
Speaker 6: a lot of intense monitoring that's done, and then sometimes
Speaker 6: it's just a case of if it's getting out of
Speaker 6: control or it's getting to a situation where it would
Speaker 6: be better for the babies to be born, they will
Speaker 6: actually make plans to deliver the babies earlier.
Speaker 3: Darry of a Birth was hosted by me Kasi Luk.
Speaker 3: It's with expert input from doctor Broman Divine. If you
Speaker 3: like our show, don't forget to subscribe and rate. It
Speaker 3: goes a long way to allowing us to continue sharing
Speaker 3: your stories. This episode was produced by Ella Maitland with
Speaker 3: audio production by Tina Mattlov