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.

The National Pharmaceutical Pricing Authority (NPPA), under the Department of Pharmaceuticals has revised the maximum retail prices of 543 anti-cancer medicines. The new rates are set to take effect from November 9, 2026. However, it does not reduce the price of Keytruda, a blockbuster immunotherapy drug used to treat more than 21 types of cancer.

India’s drug price regulator released the revised price list on October 28. The revisions come after the government’s decision to rationalise trade margins on 137 non-scheduled anti-cancer drugs, aiming to improve affordability and access to life-saving cancer treatment.

It also comes after the Supreme Court recently questioned hospitals’ staggering mark-ups on certain cancer medicines during a PIL hearing.

The updated list reflects pricing information submitted by pharmaceutical companies up to October 27. It will be revised further as manufacturers submit updated prices.

Which Cancer Drugs Have Become Cheaper?

Also read: Cancer Drug At ₹11,000, Hospital Bill ₹1.3 Lakh: SC Calls Hospital Mark-Ups ‘Loot’ & ‘Dacoity’

Several cancer medicines have undergone drastic price reductions, including drugs used in chemotherapy, targeted therapy and other forms of cancer treatment.

For instance, the price of Anarzole, a brand of anastrozole used in hormone-sensitive breast cancer, has fallen from ₹695.76 to ₹73 for a pack of 10 tablets containing 1 mg each.

The revised price of Azacytin, a 100 mg azacitidine injection marketed by Dr Reddy’s Laboratories, has dropped from ₹6,337 to ₹1,495.04.

Bevacizab, a bevacizumab injection marketed by Abbott Healthcare, has fallen from ₹21,767.70 to ₹5,930.13 for a 4 ml vial.

Other reductions include:

• Dasanat 20: The price of a pack of 60 dasatinib tablets has fallen from ₹2,812.50 to ₹1,085.93.
• Debrumab 60 mg: The price of a denosumab injection has dropped from ₹22,031.25 to ₹5,941 per pre-filled syringe.
• Enuta: The price of a pack of 28 enzalutamide capsules has fallen from ₹6,578.20 to ₹2,232.
• Fulbreca: The price of a 5 ml fulvestrant injection has dropped from ₹26,072.16 to ₹5,491.

Keytruda’s Price Remains Unchanged

Also read: From ₹6.2 Lakh To ₹15,900: Kerala Health Minister Defends Generic SMA Drug But Parents Want Safety Assurance

Despite the reductions across several cancer drug brands, the listed price of Keytruda remains unchanged at ₹2,16,500.

Keytruda, whose generic name is pembrolizumab, is an immunotherapy drug that works by helping the immune system recognise and attack cancer cells. It is used in the treatment of multiple cancers depending on the cancer type, disease stage and other clinical factors.

The drug is part of a class of medicines known as immune checkpoint inhibitors. These treatments target mechanisms that cancer cells can use to evade immune responses, helping the body’s immune system to mount a stronger attack against the tumour.

Other expensive brands, including Tagrisso, Tecentriq, Darzalex and Imfinzi, were also reported to remain unaffected by the recent price regulations.

This brings us to an important limitation of the latest revision. Reductions in the prices of selected brands do not automatically translate into lower prices for every cancer medicine.

Why Cancer Drug Prices Have Been Revised?

The latest price revisions follow the NPPA’s October 17 decision to introduce Trade Margin Rationalisation (TMR) for 137 identified non-scheduled anti-cancer drugs.

Trade margins are the mark-ups added along the distribution and sales chain. Under the measure, trade margins for the identified medicines have been capped at 30% of the maximum retail price. The intervention is intended to address excessive margins, make medicines more affordable and improve access to treatment.

The medicines covered include immunotherapy drugs used in more than 20 types of cancer, denosumab used in certain breast and prostate cancer cases, pegfilgrastim to help prevent chemotherapy-induced neutropenia, and bevacizumab, which is used for certain colorectal, ovarian and cervical cancers.

Dr. Sandeep Nayak, Chairman of Oncology, MACS-Renova Oncology Institute, KIMS Hospital, Bangalore reacted to NPPA's move. He said, "The price control introduced by the government is a positive move, as it helps bring greater uniformity to profit margins on drugs. Since the government is not controlling manufacturing prices, the move could benefit patients while bringing greater transparency to the market."

He also said that the measure could also contribute to addressing the issue of counterfeit medicines in the long run as well.

He said, "An initial assessment of the list of more than 500 drugs from various pharmaceutical companies suggests that the move is largely logical. While a detailed examination is required, the prices of many original manufacturers appear to have remained unchanged, indicating that their margins may already have been within a reasonable range."

He also expressed his concern about the drug's viability for the manufacturers.

He said, "My only worry remains that the low cost life saving drug should remain viable to manufacture and sell (eg. Tamoxifen). In the past we have seen that getting affected because of price control."

Will Price Cuts Help Cancer Patients?

Cancer treatment costs extend beyond medicines to include surgery, radiation therapy, diagnostic tests, hospitalisation and follow-up care. For patients who pay out of pocket, even a reduction in the cost of a drug can help ease some of the financial burden.

However, only patients using brands whose MRPs have fallen may see savings, while those using medicines whose prices remain unchanged may not benefit from this revision.

Patients and caregivers can check the NPPA’s updated price list or the government’s Pharma Sahi Daam app to verify the revised MRP of a specific medicine. They should consult their treating oncologist before making any changes to a prescribed treatment.

The hype around Eli Lilly’s experimental weight-loss drug retatrutide is already at peak. It may be fueled further after its Phase 3 clinical trials reported that some people with obesity and obstructive sleep apnea breathe were able to breathe more easily during sleep. Furthermore, the condition seemed to be completely resolved in at least 1 in 4 patients with type 2 diabetes.

Published in The New England Journal of Medicine recently, the trials found that retatrutide significantly lowered breathing interruptions during sleep compared to a placebo. The effects were seen in adults with moderate-to-severe obstructive sleep apnea, both with and without type 2 diabetes.

According to study co-author Dr. Virend Somers, a cardiologist and professor of medicine at the Mayo Clinic, sleep apnea was completely resolved in around 15% of participants with type 2 diabetes and 25% of those without diabetes.

Findings From Retatrutide Phase 3 Clinical Trials

The two Phase 3 trials were done on 691 adults with moderate-to-severe obstructive sleep apnoea and a body mass index of at least 27. Of these, 448 had type 2 diabetes and 243 did not.

The participants received once-weekly injections of retatrutide at doses of 4, 9 or 12 milligrams, or a placebo. Researchers followed them for 80 weeks.

The main finding was the change in the apnoea-hypopnea index (AHI), which measures the average number of times a person experiences pauses in breathing or episodes of shallow breathing per hour of sleep.

Retatrutide reduced AHI more than placebo in both trials. Participants also lost approximately 12%-22% of their body weight, depending on the dose and study group. The findings indicate that the drug could help reduce the severity of sleep apnea. However, it was only observed in a subset of participants. So, it must not be interpreted that weight loss along resulted in reversal of sleep apnea.

Also read: Retatrutide Driving Peptide-Linked Emergency Hospital Admissions In Australia: What Are The Risks?

Could Weight-Loss Drugs Improve Sleep Apnea?

Obstructive sleep apnea occurs when the upper airway repeatedly narrows or becomes blocked during sleep, interrupting normal breathing. Obesity can increase the risk because excess tissue around the neck and upper airway can contribute to airway obstruction.

Retatrutide targets three hormone receptors involved in metabolism - GLP-1, GIP and glucagon. By regulating appetite, blood sugar regulation and energy metabolism, the drug can result in substantial weight loss.

The researchers believe that reductions in body weight may help reduce airway obstruction. Participants also experienced improvements in several cardiovascular risk factors, including systolic blood pressure, LDL cholesterol and systemic inflammation.

Somers told Fox News Digital, “OSA is often under-diagnosed and under-treated.” He said he was surprised by the magnitude of the benefit among participants with type 2 diabetes, as well as the reduction in sleep apnoea severity.

Also read: Burning Skin, Panic Attack & Depression: ‘Godzilla’ Weight Loss Drug Retatrutide Linked To 129 Symptoms

Can Retatrutide Replace CPAP?

Continuous positive airway pressure (CPAP), which delivers pressurised air through a mask to keep the airway open during sleep, is the primary treatment for obstructive sleep apnoea.

The trials included participants who used CPAP and those who did not. Researchers observed that CPAP use generally declined during the study, but this does not mean patients should stop using the device without doctor’s advice.

Other treatments include mandibular advancement devices, which help keep the airway open, and positional therapy for people whose symptoms worsen when sleeping on their backs.

Sleep Apnea Is Linked With Serious Disorders

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts during sleep. The most common type, obstructive sleep apnoea, occurs when throat muscles relax and temporarily block the airway. Symptoms include loud snoring, gasping during sleep, morning headaches and daytime fatigue.

Obesity is a major risk factor because excess tissue around the neck can narrow the airway. Untreated sleep apnoea can lead to high blood pressure, cardiovascular disease and difficulties managing blood sugar.

The Supreme Court of India has slammed the steep mark-ups private hospitals charge for cancer medicines, describing excessive pricing as “loot” and “dacoity” as it considers whether tighter regulations are needed to protect patients.

During a hearing on October 27, a bench of Justices Vikram Nath and Sandeep Mehta reserved its verdict on petitions seeking stronger controls on the prices of medicines.

The court highlighted the financial burden faced by people who need life-saving treatment, especially those battling cancer, and questioned whether the government’s current pricing framework protects patients from excessive healthcare costs.

Cancer Injection Costs ₹11,000 But Billed At ₹1.3 lakh

Also read: India Caps Cancer Drug Trade Margins At 30%; Patients May Save Rs 2,500 Crore Annually

The Court was hearing a public interest litigation (PIL) filed by advocate Kishan Chand Jain who sought seeking mandatory generic drug prescriptions, stricter initial price controls on non-scheduled medicines, and statutory margin caps on medical devices under the Drug Price Control Order (DPCO).

One example cited by the court is of a medicine distributor whose wife was undergoing cancer treatment at a prominent private hospital.

According to the account presented during the hearing, the distributor offered to procure a chemotherapy injection at his dealer price of ₹11,000, but the hospital charged ₹1.3 lakh for the same medicine.

“Can you show any justification for this loot, please? Why this difference? Where does the money go?” the bench asked.

The judges also questioned the pricing of routine hospital supplies. A saline drip line with a cost ₹15 was reportedly being billed to patients at ₹250.

These examples raised questions about how medicine procurement costs, manufacturer discounts, hospital operating expenses and final patient bills are accounted for.

The Court also addressed Centre's recent decision to cap trade margins for anti-cancer drugs at 30 percent but how nearly 90 percent of medicines available in the market remain outside the purview of the Drug Price Control Order (DPCO).

"Why is the DPCO in place at all? The government is allowing this to happen. There have been three parliamentary committees on this. And their outcome is not very convenient to people who pull the strings, let us tell you," the Bench remarked.

Medicine Price Caps Under Scrutiny

Also read: 137 Cancer Drugs To Cost Up To 70% Less From November 9: NPPA Caps Trade Margins

India regulates prices of scheduled medicines under the Drugs (Prices Control) Order, 2013. The government has also introduced trade margin limits for a few anti-cancer medicines.

During the hearing, the Centre said trade margins on 137 anti-cancer medicines had been capped at 30% of the maximum retail price (MRP), a measure it estimated could save patients around ₹2,500 crore annually.

The court questioned why such interventions were limited to only a few medicines and whether a bigger and more comprehensive drug regulation was needed.

The petitions seek measures including mandatory generic prescriptions, controls on the initial prices of non-scheduled medicines and limits on trade margins for medical devices.

Hospitals And Government Raise Concerns

Representing private hospitals, senior advocate Mukul Rohatgi argued that healthcare institutions must maintain round-the-clock infrastructure and cover substantial operating costs. He also raised concerns about patients bringing medicines from outside, including the risk of counterfeit products.

The Centre maintained that medicine pricing policy must balance affordability with investment, competition and the sustainability of the pharmaceutical sector.

Additional Solicitor General Aishwarya Bhati told the court that the government continued to review its rules. The bench questioned whether these considerations addressed patients’ limited bargaining power when they need life-saving treatment.

"Your calibration is too wayward. ₹11,000 to ₹1,30,000 is no calibration. When you talk of patients and life, should we have such capitalistic thinking. Hospitals can survive through other means. Not through this dacoity,” the bench remarked, according to reports of the proceedings.

The Supreme Court has reserved its verdict. Until the order is delivered, no new price cap should be assumed. The court’s decision could influence future regulation of medicine prices and hospital mark-ups.