As the Sher-e-Kashmir Institute of Medical Sciences (SKIMS) was preparing for a breakthrough surgery to separate the conjoined twins the first ever in the medical history of Kashmir the twins passed away on Saturday evening.
The twins,joined at the thorax (chest) and abdomen were born on March 1 at the Lal Ded maternity hospital. They were brought to SKIMS,the premier hospital,on March 02,2009. The surgery to separate the baby girls was viewed by the doctors at the hospital as a major surgical undertaking.
One of the twins had developed a respiratory problem and was on a ventilator in the Surgical Intensive Care Unit of the hospital. The twins passed away on Saturday evening with the one on the ventilator getting a cardiac arrest. Since there was a communication between the two hearts,the toxins flowed from the dead baby to the other baby, said Head of the Department Paediatric Surgery,Dr Altaf Hussain Shera.
Days before the death of the twins,the hospital was weighing its options before going for the major surgery. But with the death of one of them,the hospital was forced to mobilize its resources for the surgery to save the other baby. We were forced to take emergency steps,we sent ambulances to doctors to get them to the hospital,we were ready to conduct the surgery, said Dr Shera. But it was too late,the other baby died before we could do anything.
The twins were joined from the thorax (chest) and abdomen. The doctors had diagnosed that the liver of one baby girl was crossing over to the other girl. The girls had a common liver. Also a big vein was running between the liver of one to the heart of another baby, said Dr Shera. Both the hearts had multiple congenital anomalies. One baby had three chambers in the heart instead of four and the other girl,though had four chambers had arterial and ventral septal defects. Septum is a tissue separating the chambers of the heart,so that impure and pure blood doesnt get mixed up.
Speaking on whether the doctors wasted too much time in planning the surgery,Dr Shera said,We were waiting for the twins to get stabilized. This first ever surgery in Kashmir would have been another feat for the doctors of the Institute.
Normally such risky surgeries are carried out in the second half of the first year. It is better to wait, he said. In majority of such cases all over the world,the survival chances are low. 25 per cent of the conjoined twins are born still. 50-60 per cent of those who are born die within first few days of their birth. 20-25 per cent reach the stage of surgery,the survival chances vary.
Meanwhile,the father of the conjoined twins,Nisar Ahmed,25,from South Kashmirs Kulgam district has accepted Allahs (Gods) will. It is in the hands of Allah,whatever Allah wishes,is acceptable to us, he said. The mother of the twins,Shaheena Akhtar,20,has not been told about their death. She is ignorant about their death, Ahmed confided.
Shaheena,who is still at the Lal Ded hospital,delivered a stillborn baby two years back. This was her second caesarean delivery. We will tell her after some days,it will be a shock to her, said Ahmed.
The hopeful father,Ahmed had even given them names. One was called Mashta Nisar and the other was called Hadiya Nisar. We buried them this morning at 9:30.