Multiple pregnancy rates in the UK continue to rise and pose unique challenges to how we manage pregnancy and labour. The recent case shown as part of the BBC Two TV programme Hospital shows one such complication and explains the difficulties it poses for management.
Twin pregnancy can be from the same conception (1/3 of twins, monochorionic or identical), or from 2 eggs and 2 sperm (2/3 of twins, dichorionic or non-identical). The key difference is the sharing of a single placenta in monochorionic twins which poses unique management issues in about 25% of these pregnancies.
The Liverpool Multiple Pregnancy Clinic is one of only a handful of clinics in the country dedicated solely to the management of women with a multiple pregnancy, twins, triplets or more. This clinic has been running for over 15 years. We provide a multidisciplinary team approach with midwives, sonographers and doctors who are all specialists in multiple pregnancy and fetal medicine.
The bravery of Lauren, Gary and their wider family in allowing us to tell the story of Albi and Bobby has allowed a rare insight into one of the hardest decisions any family will have to make. Laurens had a dichorionic twin pregnancy where one of her babies, Albi, had a rare condition called Anencephaly where the top of the skull does not form properly and therefore the brain is exposed in the womb. Unfortunately, this condition is not compatible with life and all babies with Anencephaly will die soon after birth. Because of this many women with a child affected in this way make the difficult decision to terminate the affected baby before delivery.
Lauren and her family took the brave decision to continue the pregnancy to consider the option of organ donation from Albi to help others, even though this could increase the risk to the whole pregnancy and Bobby, his twin. This involved a large number of people and many challenges to whether we would be able to collect any organs or not from Albi. In the end we didn’t manage to transplant anything and Albi passed away peacefully soon after birth. Lauren was able to spend some hours with Albi and he will remain an important part of their family and his brother Bobby’s life even though he is no longer here.
I would again praise the bravery of Lauren and her family in telling Albi and Bobby’s story. I hope that watching their story will be of help to others experiencing similar difficulties in the future.
Consultant and Lead for Multiple Pregnancy