hear about the successful operation to separate twins Rosie and Ruby Formosa, which took place when they were just a day old at Great Ormond Street Hospital at the end of July." />

Delight at successful separation of Formosa twins

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The twins were delivered at 34 weeks into Mum Angela's pregnancy, after doctors realised following a scan during the second trimester, that the girls were conjoined. At delivery it became apparent that Rosie and Ruby were joined at the umbilicus and that a section of their intestines was conjoined. A blockage in the intestine meant that doctors had to perform an emergency operation to successfully separate the girls when they were just one day old. Happily, their parents Angela and Daniel report that both girls are now at home and doing extremely well.

Conjoined twins are rare, with an estimated incidence of between 1:50,000 – 1:200,000 births. The twins are always identical and the phenomenon is found more frequently in girls and in African and Asian ethnic groups. There are two predominant theories as to why conjoined twins occur. Either that the originating fertilised egg splits incompletely, or that one fertilised egg splits completely, but that the stem cells from one twin attract the same stem cells of the other twin, leading to conjoinment.

Early diagnosis of conjoined twins is extremely important, so that the parents and doctors are as prepared as possible for what may follow. Modern scanning techniques and medical advances mean that this is now much more likely, particularly in the developed world. However,  it is still often difficult for doctors to ascertain the exact extent of the babies' conjoinment until they are born, and Mr and Mrs Formosa advise that this was the case in respect of Rosie and Ruby.

Conjoined twins who share a heart, brain or other major organ have a much lower chance of survival until birth or shortly thereafter, than those who share less critical parts of their bodies. Thankfully in Rosie and Ruby's case, although they were joined at the umbilicus, they did both have their own intestines. Nevertheless, the surgery to separate them will have been extremely complex and it is reported that more than 20 medical staff were involved during the operation to separate the two tiny baby girls, who would not have been able to survive without this life-saving surgery.

My congratulations go to the Formosa family and to the staff at Great Ormond Street Hospital who successfully completed this amazing operation.

Kym Provan

Senior Associate

Clinical Negligence Team 

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