In the 24th week of her pregnancy, doctors at the Nowrosjee Wadia Maternity Hospital in Parel informed Sheetal Zalte that she was carrying conjoined twins, and immediately began counselling her on the implications and the surgery that must be performed to separate them.
But any trepidations she and her husband Sagar may have had disappeared when they saw Riddhi and Siddhi running around. Conjoined at birth, the twin girls, now four, were abandoned by their parents in Raigad district. They were separated at the Bai Jerbai Wadia Hospital for Children next door, and live in the hospital. “It was after meeting Riddhi and Siddhi that Sheetal was convinced surgery would work for her children,” says Dr. Minnie Bodhanwala, CEO, Wadia Hospitals.
Luv and Prince are the third set of conjoined twins operated upon at Wadia Hospital. The first surgery was in 1993, and the twins, who are healthy, live overseas. The second was to separate Riddhi and Siddhi.
The separating
On Wednesday, 14 months after Luv and Prince were born to the Zaltes, a special team of doctors at the Bai Jerbai Wadia Hospital operated on the twins, who were joined at their lower torsos and shared a common liver, intestine, bladder and pelvic bone. The high-risk surgery, which lasted 12 hours, was begun at 4 a.m. and performed by a team of 30 doctors, including anaesthetists, gynaecologists, paediatric and orthopaedic surgeons.
To ensure the doctors remained focussed on the job at hand, the hospital shut down seven of its operation theatres (OT), keeping only one open for emergency cases. Dr. Pradnya Sawant, an anaesthetist in the medical team, said the babies were positioned on top of each other like a pair of scissors. “Giving anaesthesia to babies is generally difficult. In this case, it was tougher, as either of them could have had reacted adversely. We anticipated a lot of problems during surgery, but fortunately, there were no complications.”
Hospital authorities said the twins are admitted in the Paediatric Intensive Care Unit (PICU) and are in stable condition.
The road ahead
When they were born on September 19 last year through a Caesarian section procedure, OTs were kept ready in case an emergency surgery was necessitated, but the twins were fine after birth, says Dr. Pradnya Bendre, paediatric surgeon at the hospital. “In many cases, separation surgeries are carried out within six months of birth, but we decided let the organs grow to an optimal level.”
Dr. Sawant added. “Post surgery, the babies have been left with a small part of the liver each, which will grow in time. The babies had a common 40-cm-long intestine, which has been divided into two. The urinary bladder too has been divided, and doctors suspect they may have bladder control problems, which won’t be known till they are older.”
Their condition has been identified as xiphi-omphalo-ischiopagus tetrapus, a conjoined twinning that is considered to be rare. As they were joined at below chest level, doctors had to use a large quantity of artificial membrane after the surgery. In future, the twins may require several bone and plastic surgeries.
The Zaltes, who live in Ghatkopar, are over the moon. “It’s hard to express how happy I will be to hold a child in each arm,” says Sheetal, 26. “The doctors at Wadia Hospital explained every minute detail. It was only because of them that we sailed through.”
