neri laufer 311.
(photo credit: Hadassah Hospital)
Twin Cypriot baby girls - one growing inside
their mother's uterus and the other having developed with the placenta
attached to the exterior of the uterus and the sigmoid colon - have
been born healthy at Hadassah University Medical Center in Jerusalem.
were the second such case in the last 25 years. A multidisciplinary
team of 15 doctors worked in perfect synchrony to save the 34-year-old
mother, whose body was described as a "ticking time bomb" as well as
the babies born in their 28th week of gestation.
The excited father told The Jerusalem Post
the Hadassah team's saving of his wife and his daughters was a
"miracle. We would not have come if we did not think they would save
all of them," he said.
The government of Cyprus paid for the procedure, and he is
staying in the meantime in the Ein Kerem Hotel attached to the
hospital. "I am very happy with Hadassah and the level of Israeli
medicine. We are very grateful. I don't know how to explain what I
feel. We were very happy to come here," he added. "When our girls are
big enough, we for sure want to visit again and see again the doctors
and nurses, who were perfect."
Highly complex surgery to delivery the third-trimester
heterotopic pregnancy took three hours to prepare and two more hours to
perform. If not done properly and in time, it would have ended in the
death of all three. Hadassah doctors studied the medical file of the
first successful case in France from a decade ago and pulled together a
skilled team that included two obstetricians, an angiologist, a
urologist, intestinal and vascular surgeons, neonatologists and senior
ultrasound and MRI scanning experts.
Prof. Neri Laufer, chairman of the department of obstetrics and gynecology at the Ein Kerem medical center, told The Post
on Sunday that the girls are attached to respirators but doing very
well, even though they are 12 weeks' premature. The first to be born
via cesarean section after spending her gestation inside the womb
weighed 970 grams at her birth on Thursday night and was given the name
Marialena. Her sister Georgia Nicolleta, who spent the same period
outside the womb and received nourishment when the placenta attached
itself to the outside of her mother's uterus and colon, weighed 930
Laufer explained that factory worker Elsa Georgiou Neokleous
and her 28-year-old husband Lucas learned at a late stage in a Cyprus
hospital that one twin was in the uterus and one outside. Doctors did
not know how to save her and the twins and contacted Israel, where
Hadassah doctors agreed to handle the case despite the fact that in all
of medical history, only two previous infants had survived such a
Laufer said that one embryo apparently escaped
from one fallopian tube that had been cut during the in-vitro
fertilization procedure carried out in Cyprus. In one percent of
pregnancies, an embryo develops outside the uterus, and in 5 percent
are there twins, one inside and one outside. This happens in one out of
300,000 cases of IVF. But in the vast majority of cases, heterotopic
pregnancies are discovered during the first three months of pregnancy
and terminated because of the danger to the mother's life. If left
inside, the mother has a 10% to 20% risk of dying. If not, the fetuses
face a 70% to 95% risk of dying in the mother's body during the second
trimester; surviving into the third trimester is almost impossible.
During the open abdominal surgery to deliver them, an
uninflated balloon was inserted into the mother's aorta just in case,
to be inflated and stop blood from gushing out of any arterial hole
that might have been made by the invasive placenta.
Laufer said that as one ovary remains normal and the uterus
seems to be whole, the woman could very well be able to have additional
children in the future with IVF.