Doctors separate parasitic twin from newborn
Lalithamma and Chennabasava with their 20-day-old son
BENGALURU: When 23-year-old Lalithamma from Puladinni village in Raichur district conceived for the second time, little did she know that her second son will have a parasitic twin. Had the benefits of Janani Suraksha Yojane reached her, she would have got a prenatal ultrasound, which would have revealed the foetal abnormality. Her husband Chennabasava (26) works in a farm in his village, 60 km from Raichur.
The only silver lining was an institutional delivery in a primary health centre in Raichur on January 21. Her son weighed 3kg when he was born, not because he was healthy but because a parasitic twin who weighed more than a kilo was attached to him at the abdomen and groin.
The baby, now 20 days old, had four legs and two genitals.
The baby was referred to Jindal Sanjeevani Hospital managed by Narayana Hrudayalaya in Sandur taluk, Ballari. From then on things started looking up for Lalithamma and her newborn.
Chennabasava said, "Dr Vijay Kumar Shetty at Jindal Hospital saw pictures of my son on WhatsApp. He said my son can be operated upon. I told him I have no money for the surgery. We cursed our fate when we found our son had four legs."
The surgery
Reports were relayed through telemedicine from Ballari to NH hospital in Electronics City in Bengaluru. He was admitted there on January 24 after travelling 300km. The undeveloped parasitic twin was separated from the baby in an uneventful surgery that lasted for a little more than three hours on January 24. The hospital refused to divulge the cost of the surgery.
Prior to this thorough investigations were carried out. An ultrasound revealed that his kidneys were in good condition, X-ray of the spine and lungs were taken, an ECG and ECHO revealed that the baby had a minor heart problem. "Heart and lungs were functioning for two children. This is a huge strain for a heart that small," said Dr Sanjay Rao, senior consultant paediatric surgeon, Narayana Hrudayalaya. He was part of the 25-member team that performed the surgery.
"We found that the intestine was shared. Also, some muscles and tissue near the hip were shared. A contrast CT angiogram was performed where a dye was injected into the baby's veins to identify where the parasitic twin was getting blood supply from. We had to make sure that the urinary passage was only one. The parasitic twin was also a male," said Rao.
What caused this?
The doctors pitched two theories on why this happened. "In case of conjoined twins, the embryo splits into two but is not separated. Here the embryo did not split and the twinning process went wrong. The second theory is formation of specific types of tumours. The tumour itself matured to such an extent that it started to form body parts such as spine, bones and other organs. It is more likely a faulty twinning process," Rao said.
The mother is able to feed the baby now. The baby will be discharged soon and can soon be with his two-year-old brother.
"The baby will require follow-ups till he is two years old. That can be done through telemedicine in Ballari," said Dr Ashley D'Cruz, director and senior consultant paediatrician and urologist, Narayana Hrudayalaya.
