Two days after their birth, conjoined male twins who shared a heart, chest and liver, succumbed in a critical condition in a cardiac ambulance en route from Latur to Mumbai in the wee hours on Monday. The twins were admitted for 16 hours in the neo-natal intensive care unit of Government Medical College (GMC), Latur, where they were born to a poor rural couple.
This case, much like the country’s first harlequin ichthyosis baby born in Nagpur earlier this month, exhibits the urgent need to conduct diagnostic tests during pregnancy to detect such anomalies. The harlequin baby girl had also died three days after her birth at Lata Mangeshkar Hospital in Nagpur.
Dr Shivprasad Mundada, head of the pediatric unit at Latur GMC, said that Taslim Masasuldar (22), mother of the conjoined twins, did not undergo necessary ante-natal tests in the first 22 weeks of her pregnancy. “Conjoined twins can be diagnosed from the 12th week of pregnancy following which doctors advice medical termination till the 20th week. There is a high risk of survival if vital organs such as the heart are conjoined,” Mundada said, adding that the incidence is one in two lakh births.
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Taslim and her husband Ahmed are labourers from Saspur, a small village in Osmanabad district. According to her, there is only one public health centre in Saspur, but no facility to conduct ultrasound for pregnant women or a caesarean section. Reeling under severe drought, the couple had moved to Raigad in search of work, when Taslim underwent her first ultrasound test in the 22nd week of her pregnancy.
Immediately after realising that she had “abnormal pregnancy”, Taslim returned to her village until her labour pains started last week. With no money, the couple could not conduct further tests. On June 18, she was shifted to the Latur GMC, where a team of 12 gynaecologists operated on her for one and a half hour. “After delivery, one of the twins had breathing problems. We put them on oxygen support. Later, a decision to shift them to Sion Hospital in Mumbai was taken,” said Dr BB Yadav, head of gynaecology at GMC.
According to Dr Parag Kothari, head of the pediatric department at Sion Hospital, chances of survival of such twins even after a surgery to separate them are thin. The twins passed away despite getting cardiac care support in an ambulance on their way to Mumbai. The parents have now returned to Latur.
In 2013, Riddhi and Siddhi Pawar were born with a common vagina and urinary bladder in a remote village in Olawa near Panvel. Even then, their mother did not undergo pre-natal and ante-natal tests to detect the defect. The babies, however, were successfully operated and continue to live at Wadia Hospital.
According to Dr Pradnya Bendre, the pediatrician who operated on Riddhi and Siddhi, it is necessary for availability of ultrasound machinery in rural areas where such tests can help in detecting anomalies.”Few PHCs have, but not all,” she said.