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.

Health officials in Alberta have urged people who received injections, aesthetic procedures or other medical services from a home-based business in Edmonton to get checked for possible exposure to HIV and hepatitis B and C.

The warning was issued on August 21 after authorities said an individual, identified as Max Klein, had allegedly been providing medical and aesthetic services from a home-based, unlicensed business.

According to reports, Klein has not held an active medical practice permit in Alberta since 2015, and his registration was cancelled in 2022.

The College of Physicians and Surgeons of Alberta had previously taken action against him following a 2015 incident involving the administration of an illicit substance to a colleague without consent, according to reporting on the health alert.

Officials have asked anyone who received services from the business to contact Health Link at 811 or a healthcare provider to know if testing, monitoring or follow-up treatment is required.

People Who Received Injections May Need Blood Tests

The alert is meant for people who received a range of services, including injections, aesthetic procedures, medical treatment, and other health services from Klein. It said these individuals “may have been exposed to blood-borne pathogens, including hepatitis B, hepatitis C, and HIV” and could also face risks of injury or other health complications.

People referred through Health Link will receive a Blood and Body Fluid Exposure assessment through Primary Care Alberta. Depending on the circumstances and timing of exposure, healthcare professionals can determine whether testing or post-exposure treatment is appropriate.

Alberta health authorities said that, “Procedures involving injections, needles, or skin penetration should only be performed by a qualified provider who follows appropriate infection prevention and control practices.”

The province warned that receiving such services from “unqualified or unregulated individuals” can increase the risk of infectious disease exposure, injury and other adverse health outcomes.

Also read: From Liver Inflammation to Cancer: When Hepatitis Becomes a Serious Warning Sign

Why Can Unsafe Injections Spread HIV And Hepatitis?

Injections and other procedures involving needles can carry a risk of transmitting blood-borne infections if proper infection-control practices are not followed.

Hepatitis B, hepatitis C, and HIV can all be transmitted through exposure to infected blood. The risk can arise through contaminated needles or other equipment, particularly when sterile equipment is not used correctly or instruments are reused.

The World Medical Association notes that unsafe injection practices, including unsterilised equipment and reuse of syringes, can spread hepatitis B, hepatitis C and HIV.

Also read: England Set To Become One Of The First Countries To Eliminate Hepatitis C; Here's How

HIV And Hepatitis May Not Cause Immediate Symptoms

One reason why testing is important after a potential exposure is that blood-borne infections may not always cause noticeable symptoms soon after infection.

Healthcare professionals can determine which tests are appropriate based on the type of procedure, exposure, and how long ago it occurred.

Delhi’s air pollution may be doing more than triggering respiratory problems and heart disease. A new review by Delhi University researchers suggests prolonged exposure to fine particulate matter could also affect the brain. It said that smog could lead to changes in the brain structure, memory, attention and other cognitive functions.

Researchers examined 129 peer-reviewed studies on the neurological effects of particulate matter and found that long-term exposure to PM2.5 may contribute to cognitive impairment and structural and functional changes in the brain.

The findings are particularly relevant for Delhi, where residents can face prolonged exposure to fine particles during periods of poor air quality.

PM2.5 May Reach The Brain Through Multiple Pathways

According to the review, some of these particles may also reach the central nervous system through the olfactory pathway in the nose.

Researchers also stated that air pollution can affect the blood-brain barrier, which normally helps prevent harmful substances in the bloodstream from reaching brain tissue.

Vandana Mishra, one of the researchers associated with the review, said, “Air pollution is no longer only a lung and heart problem; it is increasingly a brain-health problem.”

She added that research now links long-term particulate-matter exposure with cognitive decline, impaired neurodevelopment and biological processes linked with Alzheimer’s and Parkinson’s diseases.

Also read: Why Everyone Is Talking About 'Inflammaging'? The Silent Cause Of Premature Skin Ageing

Pollution Can Trigger Inflammation And Oxidative Stress

The review identified several biological pathways through which PM2.5 could affect the brain. Fine particles can trigger inflammation and oxidative stress, potentially damaging cells and their connections.

Researchers also noted effects on mitochondria, the structures responsible for producing energy inside cells.

Another concern involves immune cells within the brain. Persistent activation of these cells by pollution-related inflammation may affect neurons and their connections.

The hippocampus and prefrontal cortex could be particularly be affected as they play major roles in memory, learning, attention, planning and decision-making.

Also read: Air Pollution May Increase The Risk Of Painful Rheumatoid Arthritis Flares, Study Finds

Brain Structure May Also Be Affected

The review found evidence from neuroimaging studies suggesting that chronic exposure to air pollution may be associated with reductions in brain volume and cortical thickness, particularly in the frontal and temporal lobes.

Researchers also cited studies reporting changes in the hippocampus and disruptions in connections between different regions of the brain.

These findings do not mean that every person exposed to Delhi's pollution will develop brain disease. Instead, they indicate that long-term exposure may be associated with biological and cognitive changes that need to be investigated further.

Children And Young People Particularly Vulnerable

The review also raises concerns about exposure during childhood, when the brain is still developing. Researchers cited studies reporting differences in grey and white matter volumes among children exposed to air pollution, along with possible associations with attention, behaviour and cognitive development.

Early-life exposure may be particularly important as the brain undergoes rapid development during childhood, including the formation and strengthening of connections between nerve cells.

The researchers have cautioned against interpreting the findings as proof that Delhi's air pollution directly causes Alzheimer's or Parkinson's disease.

The Democratic Republic of the Congo is set to receive 70,000 doses of Ervebo, an Ebola vaccine that was developed for a different strain of the virus that caused an outbreak more than a decade ago. As the country battles its deadliest Ebola outbreak caused by Bundibugyo virus, latest updates suggest that the death toll has topped 2000.

The vaccine was allocated by the International Coordinating Group on Vaccine Provision. Of the 70,000 doses, 20,000 will be used in a Phase 3 clinical trial to determine whether Ervebo can actually protect people against Bundibugyo. The remaining 50,000 doses will be given to frontline and healthcare workers.

Ervebo is licensed for Ebola virus caused by the Zaire strain. There is currently no licensed vaccine specifically approved for Bundibugyo virus disease.

Ervebo Was Designed To Combat Zaire Strain Of Ebola

It has since played an important role in controlling Ebola outbreaks caused by that virus. Additionally, WHO lists Ervebo as the only currently licensed vaccine for Ebola virus disease.

The problem in the current outbreak is that Bundibugyo is a different species of orthoebolavirus. That means it simply cannot be assumed that Ervebo can protect against the Bundibugyo virus.

Also read: Congo's Ebola Outbreak Is Spreading Fast But WHO Says It Can Still Be Contained In 3 Months

Early Studies Suggest Some Cross-Protection May Be Possible

If there is no certainty that Ervebo protects against Bundibugyo, then what is the scientific reason for its testing? To answer that question, WHO says early laboratory and animal studies suggest that the vaccine may provide some protection against Bundibugyo.

Some studies have also detected immune responses that cross-react with Bundibugyo virus after vaccination against Ebola virus.

WHO's guidance concluded that the available evidence was insufficient to determine or reliably estimate Ervebo's effectiveness against Bundibugyo.

Also read: DR Congo Ebola Outbreak Becomes Deadliest In Country's History As Death Toll Hits 2,325

Upcoming Trial Could Help

WHO's Technical Advisory Group updated its recommendation in July and said Ervebo should be prioritised for inclusion in a Phase 3 research study because there is no Bundibugyo-specific vaccine currently ready for evaluation.

The trial could provide the first meaningful human evidence about whether vaccination with Ervebo prevents Bundibugyo infection or reduces severe disease.

WHO has also stressed that Ervebo should not be used as a routine Bundibugyo vaccination programme outside the research settings, because its effectiveness against the current strain remains unproven.

Why A Zaire Vaccine Is Being Used During A Bundibugyo Outbreak?

The decision comes down partly to urgency and the lack of alternatives. According to the CDC, the Bundibugyo outbreak in eastern DRC has spread rapidly, with 5,375 confirmed cases and 2,557 deaths.

The virus is also circulating in areas where conflict, displacement, and population movement have made contact tracing and outbreak control particularly difficult. Waiting for a completely new vaccine to be developed, tested and approved could take much longer.

Ervebo, meanwhile, is already widely used against Ebola virus. Testing whether it provides cross-protection could therefore offer a potentially faster way to contain the outbreak.

WHO Director-General Dr Tedros Adhanom Ghebreyesus welcomed the vaccine allocation, calling it, “An important example of global solidarity in action.”

He said WHO and its partners remain committed to strengthening surveillance, rapid detection, quality care, community engagement and vaccination efforts to bring the outbreak under control.

Also read: Ebola Outbreak Is Claiming 1 Life Every 30 Minutes In DR Congo: UN Humanitarian Official

A Bundibugyo-Specific Vaccine Is Still Needed

Researchers are also working on vaccines specifically designed to target Bundibugyo. WHO says several candidates are under development, including approaches from IAVI and Oxford University, while other research groups are exploring vaccines designed to provide broader protection against multiple Ebola species.

Two vaccines specifically designed against Bundibugyo virus have entered Phase 1 safety trials in humans. CEPI-backed studies are also examining whether existing Ebola vaccines can generate immune responses against Bundibugyo, using blood samples from people who have previously received Zaire-targeting vaccines.