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Rotunda Hospital

Over 100 twins saved by laser surgery while still in the womb

The procedure involves placing a tiny camera through the mother’s abdomen and into the womb.

THE LIVES OF over 100 twins have been saved while still in the womb through the use of cutting-edge surgery at the Rotunda Hospital.

The high-tech laser surgery is carried out on twins in the womb who have a condition called twin-to-twin transfusion syndrome (TTTS), a life-threatening complication of identical twin pregnancies.

In TTTS, abnormal blood vessels in the shared placenta result in blood being transferred disproportionately from one twin to the other.


If left untreated, at least 90% of such cases result in the death of one or both babies.

A study led by the Royal College of Surgeons in Ireland (RCSI), together with The Rotunda Hospital and the National Maternity Hospital was published in the European Journal of Obstetrics and Gynaecology and Reproductive Biology.

It found that Ireland is achieving outcomes for Irish mothers and babies that are as good as those available in the world’s other leading fetal medical centres.

shutterstock_229240075 Shutterstock / Elena Stepanova Shutterstock / Elena Stepanova / Elena Stepanova

The procedure involves placing a tiny camera through the mother’s abdomen and into the womb and a laser fibre is used to find and remove the abnormal blood vessel between the twins.

This restores a separate circulation in each twin and improves complications associated with the condition including heart failure and restricted growth.

Survival rate

There was an overall survival rate of approximately 75% for those who underwent the procedure.

shutterstock_25823776 Shutterstock / sonya etchison Shutterstock / sonya etchison / sonya etchison

The condition is not preventable, which is why the senior author on the study, Professor Fergal Malone said it is critically important that pregnant women have an ultrasound examination before 12 weeks gestation to confirm twins, and to confirm whether or not both babies share one placenta.

For mothers with twins that share a placenta, it is essential that they have ultrasound examinations at least every two weeks from 16 weeks gestation onwards, so that the features of twin to twin transfusion syndrome can be discovered in time to allow life-saving fetal surgery.

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