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.

Veteran Indian actor Nana Patekar died at the age of 75 at his residence in Goa on Thursday, October 8 at 5:20 am after suffering a cardiac arrest.

His son Malhar Patekar confirmed the death. Doctors attempted CPR for around 45 minutes, but the actor could not be revived. Dr. Shekhar Salkar, Chief of Oncology Department, Manipal Hospital, said that a medico-legal case (MLC) has been registered, and a post-mortem will be conducted. Patekar's cause of death will be ascertained after the post-mortem.

Patekar's death has once again sparked attention to cardiac arrest, a medical emergency that can strike suddenly. But cardiac arrest is not the same as a heart attack, despite the two terms often being used interchangeably.

What Is Cardiac Arrest?

Cardiac arrest occurs when the heart suddenly stops pumping blood effectively to the brain and other vital organs. It is usually caused by an electrical malfunction that triggers a dangerous abnormal heart rhythm, known as an arrhythmia.

Within seconds, a person may collapse, become unconscious and stop breathing normally. Without immediate treatment, cardiac arrest can become fatal within minutes.

Unlike some medical conditions that produce warning symptoms before striking, cardiac arrest can happen abruptly, making rapid intervention crucial.

Also read: When Do You Need A Heart Check-up?

Cardiac Arrest Is Different From A Heart Attack

Basically, a heart attack is primarily a blood-flow problem, while cardiac arrest is an electrical issue. During a heart attack, a blocked artery prevents oxygen-rich blood from reaching part of the heart muscle.

The heart usually continues beating. During cardiac arrest, however, the heart's electrical system malfunctions and the heart stops pumping blood.

The two conditions are connected because a heart attack can sometimes trigger a cardiac arrest, although most heart attacks do not result in cardiac arrest.

Also read: Innovations in Structural Heart Care: The Shift Towards Minimally Invasive Therapies

CPR Can Make A Significant Difference

Cardiac arrest requires immediate medical intervention. Cardiopulmonary resuscitation, or CPR, helps maintain blood flow to vital organs until the heart can be restarted.

An automated external defibrillator, or AED, can analyse the heart's rhythm and deliver an electrical shock to restore a normal rhythm.

The American Heart Association says immediate CPR can double or triple the chance of survival from an out-of-hospital cardiac arrest.

If someone collapses suddenly and is unresponsive with no normal breathing, emergency medical services should be called immediately to start CPR.

Risk Factors

The risk of cardiovascular disease generally increases with age. Conditions like coronary artery disease, high blood pressure and abnormalities of heart rhythm can contribute to serious cardiac events. Smoking is one of the major risk factors.

There were no recent reports of Patekar's ill health. But in the past, he has spoken extensively about his heavy smoking history.

According to the Indian Express, Patekar opened about smoking around 60 cigarettes a day. He said he smoked heavily until his mid-50s and eventually quit after a personal incident made him reconsider the habit. He later said he had remained smoke-free for around 20 years.

Cardiac arrest is not exclusively a disease of older adults. It can occur in people with known heart disease as well as those who may not have previously been diagnosed with a heart condition.

Days after the death of Darya Shipilova, a 28-year-old laboratory technician in Irkutsk's Anti-Plague Research Institute, sparked global headlines about a possible pneumonic plague outbreak, reports of a suspected second case instilled concern in global health bodies and citizens.

Russia responded to the reports of the second plague case in Siberia, while the World Health Organization (WHO) says it still lacks enough information to determine what caused the death of the laboratory worker.

Initial reports suggested she could have contracted pneumonic plague following a possible laboratory exposure, although Russian authorities have not confirmed that diagnosis.

Russia Denies Second Plague Case

Also read: Second Plague Death Reported As Russia Denies Outbreak

Local media reported the second death after Baikalsk authorities issued a Telegram warning on October 3 about “unofficial information” of a confirmed plague case in Shelekhov, The Daily Mail reported.

“Due to unofficial information about a confirmed case of plague in a person in the city of Shelekhov, we ask you to limit visits to Shelekhov and nearby settlements until the circumstances surrounding this threat are clarified,” the administration said.

The post was deleted about two hours later, according to local media Lyudi Baikala. There is no official confirmation that the person had plague or died from Yersinia pestis.

Russia's public health watchdog, Rospotrebnadzor, however, has maintained that Shipilova died from pneumonia of unknown or undetermined origin, rather than plague.

The agency said nearly 5,000 laboratory tests conducted among people connected to the incident had found no dangerous pathogens. More than 90% of the people who were placed under medical observation had completed monitoring.

Rospotrebnadzor also said Shipilova had been vaccinated and had immunity against the dangerous infections she worked with. It said there was no epidemic risk in the region.

The Kremlin has also rejected reports of a second suspected case. Kremlin spokesman Dmitry Peskov said the majority of media reports surrounding the incident were false and urged people to rely on official statements from Rospotrebnadzor.

According to Reuters, “There is a great deal of media coverage, and the vast majority of what the media are reporting about this situation is false information,” Peskov said.

WHO Investigates Lab Worker's Death

Also read: Russia Tells WHO No Plague Cases In Irkutsk, But Lab Worker's Death Remains Unexplained

Despite Russia's reassurances, the WHO says important questions about the lab worker's death still remain unanswered. WHO Director-General Tedros Adhanom Ghebreyesus said the organisation has requested details of the laboratory testing carried out on Shipilova and her contacts, the reasons behind the public-health measures and the current health status of those monitored.

The WHO has also asked Russia to verify reports that a second employee developed pneumonia of undetermined cause.

“As we don’t yet have the full picture of this event, we are not able to conduct a full risk assessment,” Tedros said. He stressed that timely, complete and transparent information is necessary to establish what happened and assess any potential public-health risk.

Maria Van Kerkhove, WHO director of epidemic and pandemic management, said the agency does not yet know the causative agent behind Shipilova's death.

“Right now, we don't know the causative agent of how this woman died. And that's really what we want to better understand,” she said.

Bioweapon Claims

There's also uncertainty which has prompted questions in the US about whether the incident could involve a biological weapon.

US President Donald Trump was asked on October 7 whether he believed the Russian lab worker's death was linked to a bioweapon, US President Donald Trump said: “We don't think so. We're going to find out soon enough, but we don't think so.”

He also said his administration was in “very deep discussions” about the incident and that he had a call with Russian President Vladimir Putin scheduled.

US officials, meanwhile, have continued monitoring the situation. CDC Director Erica Schwartz said the agency was prepared to monitor and screen travellers.

Secretary of State Marco Rubio said Washington was monitoring reports of possible plague but said they were not a “cause for alarm”. “There’s very limited travel between the US and Russia, obviously, but like anything else, something like that gets out, it could quickly spread,” Rubio said.

“So we're watching and monitoring it closely. I don't think it's cause for alarm – but it is cause for focus and a cause to just keep an eye on it. And we're doing that.”

Meanwhile, neighboring countries including Mongolia, Kyrgyzstan and Uzbekistan have reportedly tightened border health measures.

Novartis’ drug remibrutinib can now also be used for adults with symptomatic dermographism, according to the US Food and Drug Administration (FDA).

Marketed as Rhapsido, it is the first FDA-approved treatment specifically for symptomatic dermographism in adults whose symptoms do not sufficiently respond to H1 antihistamines.

Symptomatic dermographism is a condition is a form of chronic hives in which even minor scratching, rubbing or friction can trigger itchy, raised welts on the skin.

This has led Rhapsido to become the only prescription treatment in the US with approved uses for both symptomatic dermographism and chronic spontaneous urticaria when antihistamines alone are insufficient.

FDA Approves Remibrutinib For Symptomatic ermographism

The move came after symptomatic dermographism cohort of the Phase III RemIND trial, which included adults who remained symptomatic despite treatment with second-generation H1 antihistamines.

After 12 weeks, 29.3% of patients taking remibrutinib treated hives completely, compared to 14% of those receiving placebo. Novartis said improvements were seen as early as two weeks.

“SD is a chronic, debilitating condition with historically limited treatment options,” said Giselle Mosnaim, MD, MS, lead RemIND trial investigator. “Remibrutinib offers, for the first time, an approach to treatment specifically for SD patients who remain inadequately controlled with H1 antihistamines alone, representing a meaningful step forward for this population.”

Also read: HPV Vaccine May Keep Cervical Cancer Risk Lower In Women With HIV For Years: Lancet

What Is Symptomatic Dermographism?

Dermographism, sometimes called 'skin writing', occurs when the skin develops raised marks or welts after being scratched or pressurised.

In symptomatic dermographism, the reaction is accompanied by significant itching and hives. A person may develop welts after scratching an itch, rubbing against clothing, carrying a bag, drying off with a towel after a shower or any other everyday friction.

The welts can appear within minutes of the physical trigger, making ordinary contact with the skin unexpectedly uncomfortable.

Symptomatic dermographism is classified as a form of chronic inducible urticaria, meaning the hives are triggered by a specific physical stimulus rather than appearing spontaneously.

Also read: New Lymphoma Trial: Experimental Drug Combination Cuts Progression Or Death Risk By 51%

Why Scratching Cause Hives In Symptomatic Dermographism?

The reaction of hives forming after scratching involves mast cells, immune cells found in the skin that can release histamine and other inflammatory substances. When the skin is physically stimulated, these cells activate, triggering the characteristic redness, swelling, and itching.

This is also where remibrutinib works differently from conventional antihistamine. Remibrutinib is an oral, highly selective Bruton’s tyrosine kinase (BTK) inhibitor.

By blocking the BTK process that is involved in immune-cell signalling and histamine release, the drug aims to reduce the chain of events that produce hives and itching.

Living With Symptomatic Dermographism

For most people, the condition is primarily a chronic quality-of-life problem rather than a life-threatening disease. However, persistent itching and unpredictable hives can interfere with sleep, clothing choices, work, and everyday activities.

The FDA approval does not mean remibrutinib is intended for everyone with dermographism. It is approved for adults whose symptomatic dermographism cannot be controlled by existing H1 antihistamines.

The most common adverse events reported with remibrutinib in trials included nasopharyngitis, bleeding, headache, nausea and abdominal pain.