Singer Jesy Nelson recently shared an emotional update regarding the complications she is experiencing in her pregnancy with twin babies. Former Little Mix singer Jesy, who is having twins with partner Zion Foster, announced that she has been diagnosed with pre-twin-to-twin transfusion syndrome (pre-TTTS). The condition, which is present in pregnancies involving twins with a shared placenta, has serious risks involved and needs intense medical supervision. As Nelson embarks on this difficult journey, her story enlightens us about a rare but dangerous condition many expectant parents may not know much about.

Twin-to-twin transfusion syndrome is a rare but dangerous condition that arises in monochorionic twin pregnancies, in which identical twins share a single placenta. The placenta supplies the developing babies with oxygen, nutrients, and blood flow, but in TTTS, there is an imbalance of blood vessels that interconnect the twins, and thus the vital resources are not evenly distributed. One twin, or the donor twin, shares excess blood with the other, referred to as the recipient twin. This leads to one baby becoming malnourished and possibly anemic, and the other in danger of heart problems due to too much blood.

Nelson described her diagnosis in a heartfelt Instagram video, explaining that she is currently in the pre-stage of TTTS and undergoing frequent monitoring. "I am being scanned twice a week, and each time, things have gotten a little worse," she shared, expressing her fears and hopes for the health of her babies.

Potential Risks of TTTS

If left untreated, TTTS can have devastating consequences. Medical research indicates that:

• 90% of the cases of untreated TTTS lead to loss of one or both twins.
• Despite treatment, only a 70% survival rate for both twins is assured.
• Severe forms can result in preterm labor, cardiac failure in the recipient twin, and organ failure in the donor twin.
• Complications in long-term survivors include neurological damage and developmental delay in surviving infants.

TTTS usually advances in stages, beginning with minimal changes in fluid levels and worsening as one twin continues to get an unequal share of blood. In extreme cases, fetal laser surgery, referred to as the Solomon technique, can be employed to divide the blood vessels and balance the twins.

Why Identical Twin Pregnancies Are More Complicated

Identical twins may develop differently, and their own unique form of placental sharing can have a dramatic effect on pregnancy risk. Jesy Nelson's twins are considered monochorionic diamniotic (mono/di), which means they share a placenta but have two amniotic sacs. This is the type of pregnancy in about 70% of identical twin pregnancies and carries an increased risk of complications like TTTS, umbilical cord entanglement, and growth restriction.

Conversely, dichorionic diamniotic (di/di) twins both have a separate placenta and amniotic sac, which greatly diminishes the threat of TTTS. Twin pregnancy type is normally identified by early ultrasound, with physicians being able to track future complications from inception.

Other Twin Pregnancy Health Risks

Twin pregnancies, even without the presence of TTTS, entail a variety of health risks to the mother as well as infants:

1. Premature Birth

Over 60% of twin pregnancies end in premature delivery, with birth usually taking place before 37 weeks. Premature infants can have immature organs and need neonatal intensive care (NICU) assistance to assist with breathing, feeding, and infection fighting.

2. Gestational Hypertension and Preeclampsia

Pregnant women with multiples are at increased risk of having high blood pressure during pregnancy. This, if left untreated, can result in preeclampsia, a serious complication of pregnancy that can result in damage to organs, preterm labor, and in some cases, maternal or fetal death.

3. Anemia

Pregnant women carrying multiples are twice as likely to experience anemia, a condition where the body does not produce enough healthy red blood cells. This can lead to fatigue, dizziness, and complications during delivery.

4. Birth Defects

According to John Hopkins Medicine, multiple birth babies are twice as likely to have congenital abnormalities compared to single births. These can include heart defects, neural tube defects, and gastrointestinal issues.

5. Amniotic Fluid Imbalances

When twins have to share a placenta, they are more likely to have polyhydramnios (excess amniotic fluid) or oligohydramnios (not enough amniotic fluid). Both result in distress to the babies during fetal development and can result in premature labor.

6. Postpartum Hemorrhage

Twins are at increased risk of excessive postpartum hemorrhage because their uterus is larger and there are greater blood supply needs.

Jesy Nelson's openness about her challenging experience is raising awareness for TTTS, a condition that few individuals—let alone expectant mothers and fathers—might be aware of. Through her tearful video, Nelson stressed the significance of knowing about twin pregnancies aside from the thrill of having multiples. "We had no idea that this type of thing occurs when you're having twins. We just desperately want to make people aware of this because there are so many people who aren't aware."

Her case reminds us of the intricacies involved in twin pregnancy and the significance of early identification and medical management. For mothers carrying twins, frequent ultrasounds and vigilance can become a life-and-death issue for early detection and better outcomes of both babies.

Through constant medical attention and care, she and her partner Zion Foster remain positive and get ready for their babies to be born. In other parents whose situations are no different, the story of Nelson highlights awareness, medical progress, and emotional encouragement in handling complicated pregnancies.

The expecting parents of twin siblings are advised to discuss TTTS screening and possible interventions with their physicians to give their babies the best chance.

While the devastating COVID-19 pandemic has significantly increased awareness about zoonotic diseases, the world remains inadequately prepared for another outbreak, which is "very likely," according to Dr Mario Raviglione, consultant to a HPV project at the International Agency for Research on Cancer (IARC), World Health Organization, on the occasion of World Zoonoses Day.

Observed every year on July 6, World Zoonoses Day aims to raise awareness about zoonotic diseases—infections that spread between animals and humans. This year's theme, "One World, One Health: Prevent Zoonoses," underscores the close link between human, animal and environmental health, according to the International Society for Infectious Diseases (ISID).

In an exclusive interview with HealthandMe, Dr Mario said the world has learned important lessons from COVID-19, but preparedness for the next zoonotic outbreak remains inadequate.

"The biggest lessons learned in my view are the understanding... that indeed we are in an era where pandemics could happen on a daily basis essentially," he said, noting that around three-quarters of emerging and re-emerging infections now originate in the animal world.

However, despite greater awareness among politicians, policymakers and health ministries, he said there is still no full understanding of the level of preparedness needed to confront future threats.

Risks Of Pandemics Are Increasing

According to Dr Mario, the factors driving zoonotic spillovers are becoming more intense rather than diminishing. He pointed to:

• Expanding human populations moving into previously wild areas

• Increasing proximity between humans and animals

• Rapidly growing livestock production

• Unrestricted animal trade

• Deforestation

• Biodiversity loss

• Greater contact with disease-carrying vectors such as mosquitoes.

"All of this put together tells us that the risk is high, that the risk is increasing, that the pandemic potential is definitely on an increase and, as a result, preparedness becomes really at this point an imperative," he said.

Plans Exist, But Funding Is Lacking

While acknowledging that many countries, particularly in Europe, now have pandemic preparedness plans, Dr Mario said these are often not backed by adequate financial commitments.

He said many countries continue to face shortages of trained human resources, laboratory capacity and disease surveillance systems. There are also insufficient links between human medicine, veterinary public health and environmental monitoring.

According to him, these shortcomings remain significant obstacles to effective preparedness and response during future epidemics, particularly in low- and middle-income countries.

Surveillance And Laboratory Capacity Need Strengthening

Dr Mario, also a consultant for a tuberculosis project with the US National Institutes of Health (NIH), stressed that countries need stronger surveillance systems not only for human diseases but also for animals and the environment.

He also highlighted the need for improved laboratory capacity to identify emerging pathogens, stronger genomic surveillance, adequate facilities and trained personnel, and the ability to rapidly produce vaccines when needed.

"The environmental health is the one that is weaker... in terms of capacity to monitor," he said, describing it as the weakest component of the One Health triad.

One Health Approach Is Essential

Dr Mario said zoonotic diseases emerge from interactions between humans, animals and the environment, making the One Health approach fundamental to future pandemic preparedness.

He described One Health as "an approach that unites human health, animal health and environmental health," recognizing that all three are interconnected.

He said practical implementation should include:

• Human disease surveillance

• Veterinary surveillance

• Biodiversity and wildlife monitoring

• Food safety systems

• Stronger diagnostic capacity

• Laboratory networks

• Antimicrobial resistance plans

• Research capability

• Adequate vaccine manufacturing capacity

Prevention Requires Sustained Investment

Despite the increased awareness following COVID-19, Dr Mario said preparedness ultimately depends on governments translating commitments into action through sustained investment.

He said countries need solid preparedness plans, practical implementation and adequate financing to build resilient systems capable of responding to future threats.

"If you think prevention is expensive, try the disease then," he said, underscoring the importance of investing in prevention.

Women who are conflicted while choosing between an injectable contraceptive, a copper intrauterine device (IUD) or a hormonal implant may not need to worry about its impact on human papillomavirus (HPV).

What Is Human Papillomavirus (HPV)?

HPV is one of the most common sexually transmitted infections worldwide. While many HPV infections go away on their own without causing problems, some high-risk types can persist and increase the risk of cervical cancer in the long run.

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Before this study, scientists debated whether hormonal contraceptives could affect a woman's immune response, making it easier to contract HPV or harder for the body to clear the infection.

Birth Control Choice May Not Influence HPV Risk

According to a new study published in The Lancet Regional Health – Africa, your choice of contraception may not have an impact on the risk of contracting HPV.

Researchers found that women using a commonly used injectable contraceptive known as depot medroxyprogesterone acetate (DMPA-IM), copper IUDs, and levonorgestrel implants had similar chances of contracting HPV and clearing existing infections.

About The Lancet Study

Also read: You Can Still Get HPV If You're Not Sexually Active

The researchers examined data from women who participated in the large ECHO (Evidence for Contraceptive Options and HIV Outcomes) clinical trial. Participants were randomly assigned to one of three contraceptive methods:

• Depot medroxyprogesterone acetate (DMPA-IM) injectable contraceptive

• Copper IUD

• Levonorgestrel implant

They then compared how often women acquired HPV during the study and how often those who already had HPV were able to clear the infection naturally. The analysis found no meaningful differences between the three contraceptive methods.

Women using the injectable contraceptive were no more likely to acquire HPV than those using a copper IUD or a hormonal implant. Similarly, women across all three groups cleared HPV infections at comparable rates.

Significance Of The Study

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Earlier studies finding the link between hormonal contraceptives and HPV have reported mixed results. Some suggested that hormonal birth control might increase the risk of HPV infection or make infections last longer, while others found no clear outcomes.

This new research provides stronger evidence because it is based on a randomized clinical trial. The findings suggest that the type of contraceptive a woman chooses is unlikely to have an impact on her risk of getting HPV or her body's ability to clear the infection.

Women Can Take Control Of Their Contraceptive Choice

The study allows women to choose between these commonly used contraceptive methods based on factors such as effectiveness, convenience, side effects, and personal preference, rather than concerns about HPV risk.

However, experts stress that no contraceptive method protects against sexually transmitted infections, including HPV. Using condoms can help reduce the risk of HPV and other STIs.

The human papillomavirus causes more than 200 known infections. While some types lead to benign skin warts, others are responsible for severe health threats, such as cervical, throat, anal, and penile cancers. The HPV vaccine provides strong protection against the most lethal strains, avoiding long-term health complications.

The HPV vaccine helps the immune system recognize and fight off high-risk strains of the virus before they cause harm. It protects against:

• Genital warts

• Cervical cancer

• Vaginal, vulvar, anal, and penile cancers

• Mouth, throat, head, and neck cancers linked to HPV

Experts also stress that HPV vaccination and regular cervical cancer screening remain the most effective ways to prevent cervical cancer and detect abnormal changes early.

People in the UK can, from today, access the Wegovy weight loss pill through pharmacies with a doctor's prescription. It is the first oral glucagon-like peptide-1 (GLP-1) medicine approved in the UK for weight loss.

The Medicines and Healthcare products Regulatory Agency (MHRA) approved the tablet on June 11, marking the first oral GLP-1 treatment available in the country for obesity management.

"Having met the MHRA's rigorous standards of safety, quality and effectiveness, the semaglutide tablet has been approved in the UK for weight loss and weight management," Julian Beach, Executive Director of Healthcare Quality and Access at the MHRA, said in a statement.

"As with all GLP-1 receptor agonists, this is a prescription-only medication," Beach added.

Novo Nordisk called it an "important milestone for obesity care in the UK".

"For the first time, people living with obesity have access to a GLP-1 treatment in a daily pill, allowing them the choice and flexibility of oral treatment to support their long-term weight management," said Sebnem Avsar Tuna, General Manager at Novo Nordisk UK.

Wegovy Weight Loss Pill: Who Is Eligible?

Also read: US Medicare Set To Cover GLP-1 Drugs For Weight Loss: All You Should Know About Eligibility, Costs

The semaglutide (Wegovy) tablet can be prescribed alongside a reduced-calorie diet and increased physical activity for adults who:

• Have obesity (BMI of 30 or above), or
• Are overweight (BMI between 27 and 30) and have at least one weight-related comorbidity.

Wegovy Weight Loss Pill Dosage

Patients must begin with the lowest dose of 1.5 mg once daily, which can be gradually increased to:

• 4 mg
• 9 mg
• 25 mg

People currently taking 2.4 mg weekly semaglutide injections privately can switch directly to 25 mg semaglutide tablets once daily.

Wegovy: How To Take The Tablet

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According to the MHRA, the tablet should be:

• Taken whole on an empty stomach after fasting for at least eight hours.
• Swallowed with a small sip of water.
• Followed by no food or drink for at least 30 minutes, as eating or drinking sooner reduces the drug's absorption.

Patients are advised to carefully follow the instructions in the Patient Information Leaflet.

How Does Wegovy Work?

Semaglutide is a GLP-1 receptor agonist that mimics the action of the naturally occurring GLP-1 hormone released after eating.

It acts on areas of the brain that regulate appetite by:

• Helping people feel fuller for longer.
• Reducing hunger.
• Decreasing food cravings.

Wegovy: Is It Available On The NHS?

Not yet. Although the medicine has received MHRA approval, it is not currently available through the NHS.

The MHRA said NHS availability will depend on the usual evaluation process by the National Institute for Health and Care Excellence (NICE).

NICE said Novo Nordisk has not yet formally approached it, but that it is in active discussions with the company, BBC reported.

Wegovy Weight Loss Pill: What Are The Side Effects?

The most commonly reported side effects are gastrointestinal and include:

• Nausea
• Diarrhea
• Constipation
• Vomiting

The MHRA said it will continue to monitor the medicine's safety and effectiveness. Anyone experiencing side effects should speak to their doctor, pharmacist, or nurse and report them through the MHRA Yellow Card scheme.

Pharmacies Expect High Demand

Community pharmacies say they are preparing for a surge in demand following the launch. The National Pharmacy Association (NPA) urged patients to obtain the medicine only from regulated pharmacies following a proper clinical consultation.