Siamese twins to be split `within first year'

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The Independent Online
LIZ HUNT

Health Editor

Separation of the Siamese twin girls due to be born at a Manchester hospital in the next 10 days will probably take place during their first year of life, surgeons said yesterday.

The parents of the twins, the first to be born in the UK for nine years, have made it clear to doctors at St Mary's hospital that they want their daughters to be separated as soon as it is safely possible.

Scans suggest that the baby girls, already named Nichole and Chloe, are at "the better end of the spectrum" of conjoined twins, according to Alan Dickson, a paediatric surgeon and leader of the foetal therapy team now monitoring their mother, Melanie Astbury, 25.

The twins are joined from breast bone to navel but appear to share only the liver. This would have to be split, a relatively straightforward procedure. Liver cells are resilient with a remarkable capacity to regenerate.

At a press conference yesterday, Mr Dickson said other abnormalities may be present which could influence the success of a separation operation. "We would hope to separate them in the first year of life but there can be no decision until we have all the information from various scans and investigations. In general terms, the problems are the organs inside the abdomen. These will have to be divided and shared. It is also possible there won't be two full sets of organs."

He said that Mrs Astbury and her husband, Brian, from Denton, Greater Manchester, had been warned of the difficult decisions they faced "if the anatomy is unfavourable". However, if the babies are born healthy they can expect a good quality of life in their first few months.

Dr Sarah Russell, a consultant clinical radiologist, said what the scan had shown so far was "the tip of the iceberg". She said: "It would appear the twins share a liver. There may be other abnormalities that can't be detected by the scan."

Dr Michael Maresh, the consultant obstetrician who will deliver the babies, said the pregnancy was "progressing well" and there were no immediate plans to perform the Caesarean. He has delivered two sets of Siamese twins previously. "The obstetric issues are relatively straightforward," he said. "She is being managed essentially like anyone with a twin pregnancy.

"It is complicated a little by the fact we are delivering two at one time so we will have to make a larger incision, but that is not a great problem. The pregnancies are still at risk, as are any twin pregnancies, but at the moment we are not unduly concerned."

A spokeswoman for St Mary's said no contact had yet been made with Great Ormond Street hospital, London, regarded as a centre of expertise for the separation of Siamese twins. Five separations have been completed there since 1984. Two sets have survived to date. One set, Italian boy twins, survived for the first year and then one twin died. Of the remaining two sets, just one twin survived in each.

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