Top Royal Hospital for Women surgeon saves Maroubra twins
A LEADING surgeon saved two unborn twins by carrying out laser surgery on the girls while they were still inside the womb.
Southern Courier
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IT’S every couple’s nightmare. To be pulled into the doctor’s office and told there’s a complication.
For Kathryn and Phillip Hanly, from Maroubra, that complication was their unborn twins had what is known as twin to twin syndrome.
The Royal Hospital for Women’s Professor Alec Welsh was blunt when he met with the couple in December last year. If nothing was done there was an 80 per cent chance one of both of babies wouldn’t make it.
Most identical twins grow in the womb with two placentas with blood and nutrients received separately through each babies’ umbilical cords.
But Eleanor and Aisling shared a placenta, which meant the blood vessels carrying their nutrients and blood were interconnected. Blood was also passing from one twin to another.
Eleanor was receiving too much blood from Aisling, putting intense pressure on her heart. Meanwhile, Aisling was giving too much of her blood and nutrients to Eleanor and was at risk of dying from the lack of oxygen.
“We had the option to terminate which we didn’t even consider,” Kathryn said. “The second option was to remove some of the amniotic fluid, but that wouldn’t help the smaller twin. Then he told me he could operate.”
Rose Bay’s Prof Welsh, who is considered one of the best in his field, doesn’t sugar-coat his consultations. “I don’t think you can,” he said. “I try to be blunt but compassionate. I tend to start most conversations by apologising if I come across too harsh. Ninety nine times out of a hundred couples prefer that honesty.”
But what was it like for Kathryn? “Let’s put it this way, they gave me a box of tissues to take home because I couldn’t get out the building I was crying so much.
“But I needed that directness. There is so much internal noise going on that you need someone to be frank and to explain it all.”
It was a daunting situation for her, especially as Phillip had flown back to Ireland after the sudden death of his father (he raced back have been told by Kathryn about the operation).
But the percentages spoke for themselves. If Kathryn was to go through with surgery there was a 60 per cent chance both babies would go home with her and a 90 per cent chance one would survive.
The surgery is as daunting for the mother as it is incredible.
Prof Welsh explained he would operate on the twins while still inside the womb. He would use a laser to seal off many of the blood vessels to stop the blood flowing between the twins. By doing this, he divided Kathryn’s placenta in two so that each twin was receiving equal proportions of nutrients.
While most surgeons have one life in their hands on the operating table, Prof Welsh had three.
“You can’t let yourself get overwhelmed by the magnitude of what you are doing otherwise you wouldn’t be able to function.
“You just train yourself to be very focused on the job and not the consequences.
“I guess for me it is a one-on-one contract. I have a contract with a couple to carry this out to the best of my abilities.
“It sounds silly but I frequently meditate before I go and do procedures like this. Just to get myself grounded and focused. I also have techniques during a procedure if it becomes a bit complex.”
Despite the situation, Kathryn, who was only under local anaesthetic, was calm.
“I know I was in the best hands in Australia if not the world. We are so lucky to have this hospital on our doorstep.”
The operation appeared to have gone well. But the following 24 hours were crucial and only a scan the following morning would reveal if both had survived.
“I remember they found one heartbeat and then the woman doing the ultrasound said ‘shall we do the measurements?’ I just wanted her to find that second heartbeat.”
They did and as the weeks went on both girls started to develop well.
They were delivered by caesarean section at 34 weeks and after eight weeks in the neonatal unit they were ready to go home.
Much of their care was provided by the premature babies ward, where 70 per cent of the equipment is funded by the Royal Hospital for Women Foundation.
“I promised after surgery that I would introduce them to Prof Welsh and the other members of his team (Dr Lalla McCormack, Dr Margaret Harpham and midwife Sandra Emerson) when they were born,” Kathryn said. “Without him, they wouldn’t be here. It’s as simple as that.”
“He become so much more than a medical professional. He has become a friend,” Phillip said, now more than six months on from the operation.
“They’ve been through a lot already,” Kathryn said. “They’re real fighters. So perhaps you are looking at a future Australian Prime Minister.”