23 July 2009

Separated twins go home for first time

The Siamese twins Mandilive and Masilive Jiba (1), that were successfully separated at the Red Cross hospital earlier this year, have returned home.

The Siamese twins Mandilive and Masilive Jiba (1), that were successfully separated at the Red Cross hospital earlier this year, have returned home.

Mandilive and Masilive was born on May 8 last year in Lusikisi in the Eastern Cape conjoined at the chest and stomach.

Three days after their birth, the twins and their mother, ms. Nontle Jiba, were taken to the Red Cross Children’s Hospital in Cape Town where various sets of conjoined twins have been successfully separated since 1964. During a 6-hour operation on May 13 this year a team of 20 surgeons, nurses and anaesthetists successfully separated Mandilive and Masilive.

Jiba said she is very thankful and happy to be taking her children home after a year’s stay in hospital. She has two other children, aged 11 and 5.

Social workers and nurses at the Red Cross Children’s Hospital were saddened by the twins’ departure. “It is wonderful, but I will miss them,” said nurse Michele Maree.

Twins should be healthy
According to Prof Alp Numanoglu, one of the doctors who performed the operation, the twins should be healthy in future.

“At a later stage we have to look at their bone structure that may give problems because they were awkwardly positioned for a year. I don’t think there will be any other big complications,” said Numanoglu.

He said the operation took a lot of preparation and Mandilive and Masilive’s separations was one of the more difficult operations of its kind that have been done at the hospitals.

They each had their own heart, but it was in a single pericardial sac, which had to be separated.

They also shared a liver and a prosthetic was used to repair their sternums and stomachs.

Why twins are sometimes conjoined
A Siamese twin originates from a genetic defect during the process of embryo formation. A defect in the doubling of genetic material leads to incomplete cell division. The result is a pair of identical twins who are joined at the hips, chest, back or head – the place where the cells didn't separate completely.

A study by the department of paediatric surgery at the Red Cross Children’s Hospital showed that almost 70% of Siamese twins are girls. The single biggest factor preventing separation is the sharing of a single heart.

In almost 74% of cases of Siamese twins treated and separated at the Red Cross Children’s Hospital, the children were joined front to front at their breastbone or tummy, in 19% they were joined back to back at the lower section of their spine, and 6% were joined at their hips, facing each other. Less than 2% were joined at the head.

The separation of Siamese twins involves complex surgery, and medical and ethical dilemmas. Siamese twins can consist of two equally developed babies only physically attached to each other; but sometimes consist of a dominant baby with parts of the second twin – like a baby born with 4 legs or two heads.

With medical and technological advances more Siamese twins can be saved – either both or at least one – when separated. – (Marlene Neethling, Die Burger/Health24, July 2009)

Read more:
Twins stable after separation




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