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.

From 130 maternal deaths per lakh live births during 2014–16, India has achieved a 43-point reduction in the Maternal Mortality Ratio (MMR) between 2022 and 2024, according to the government.

Currently, the MMR in the country stands at 87 maternal deaths per lakh live births.

In an official statement, the government credited the achievement to Pradhan Mantri Surakshit Matritva Abhiyaan (PMSMA), which today completed a decade.

Launched in June 2016, PMSMA provides free, comprehensive antenatal care to pregnant women at designated government health facilities on the 9th of every month.

More than 7.50 crore pregnant women have received antenatal services under PMSMA in addition to routine ANC check-up services in the last 10 years. The Extended PMSMA, launched in 2022, strengthens follow-up care and tracking for high-risk pregnancies.

"Over the past decade, the Pradhan Mantri Surakshit Matritva Abhiyaan has transformed the delivery of antenatal care in India. Quality maternal healthcare is now more accessible, systematic and responsive," the statement said.

“The remarkable decline in the Maternal Mortality Ratio from 130 to 87 over the past decade demonstrates how focused interventions can save thousands of lives,” it added.

How PMSMA Works

The government noted that PMSMA works through:

• Early identification of high-risk pregnancies
• Regular monitoring
• Timely medical intervention

"PMSMA has demonstrated that when quality healthcare reaches women at the right time, it saves lives, prevents complications and creates healthier beginnings for families and future generations," the govt said.

Services Offered Under PMSMA

The PMSMA service package includes clinical examinations, laboratory investigations (blood and urine tests), ultrasonography, medicines, and counselling on nutrition, birth planning, and safe pregnancy practices.

Key features include:

• Minimum one comprehensive and quality antenatal check-up by an Obstetrician and Gynecologist or a Comprehensive Emergency Obstetric and Newborn Care (CEmONC) trained doctor during the second or third trimester.
• Mobilizing pregnant women for specialist antenatal care services at designated public health facilities.
• High-risk pregnancy identification by screening for 25 high-risk factors and management at an early stage.
• Linking high-risk pregnancies to the nearest First Referral Unit (FRU) for safe delivery.
• Empanelment of private service providers for PMSMA service provision.
• Essential blood and urine investigations and ultrasonography.
• Counselling on nutrition, appropriate birth planning, and complication readiness for every pregnant woman.

Who Can Access PMSMA Services?

The program is available to:

• Pregnant women in their second trimester (13–27 weeks) or third trimester (28 weeks until delivery).
• Indian citizens residing in India who are willing to visit designated government health facilities on the 9th of every month.
• High-risk pregnancy cases, which receive priority attention and follow-up care.
• Women who are dropouts from regular antenatal care and are actively encouraged to participate.

What Is Maternal Mortality Ratio?

MMR is defined as the number of maternal deaths per one lakh live births during a given period.

A maternal death refers to the death of a woman during pregnancy or within 42 days of termination of pregnancy due to causes related to or aggravated by the pregnancy or its management, excluding accidental or incidental causes.

Maternal health remains one of the clearest indicators of the strength and inclusiveness of a country's healthcare system.

"As India marches towards Viksit Bharat@2047, PMSMA will continue to transform the maternal healthcare landscape by ensuring that every pregnancy is safer and every mother receives the care she deserves. With continued commitment and collective action, PMSMA can help usher in an era where no woman loses her life while giving life, strengthening the foundations of a healthier and more prosperous India," the statement said.

Health officials in Kerala have reported two deaths caused by West Nile fever in Ernakulam district.

The deceased was identified as Muraleedharan, a 70-year-old man from Kadangalloor near Aluva. The elderly man died while undergoing treatment on Monday at Kalamassery Medical College, officials said.

Muraleedharan, who was suffering from cancer and had respiratory problems, was admitted to the Medical College Hospital a few days ago with symptoms of West Nile fever. This is the second death from West Nile fever in the Ernakulam district in a week.

Saraswathiyamma, a native of Paravur, died of West Nile fever the other day. Many people have reportedly sought treatment at various hospitals in Ernakulam district with West Nile fever and dengue fever symptoms.

Health Department Issues Advisory

Following the incident, the state health department urged people to remain cautious and also issued an advisory urging the public to take precautions against the mosquito-borne disease.

The West Nile Fever "is caused by a flavivirus commonly found in migratory birds and is transmitted to humans through the bite of infected mosquitoes," the department said, in a statement.

It clarified that "the disease does not spread from person to person and that preventing mosquito bites is the most effective way to avoid infection".

According to health authorities, symptoms may include fever, high body temperature, stiffness of the neck, behavioral changes, confusion, semi-consciousness, or loss of consciousness, PTI reported.

The statement warned that severe infection could affect the nervous system and lead to conditions such as encephalitis and meningitis.

"Elderly persons, those with low immunity, individuals with underlying illnesses, pregnant women, and children have been identified as high-risk groups requiring special attention. Culex mosquitoes, which breed in stagnant and polluted water bodies, drainage channels, septic tanks, marshy areas, paddy fields, and overgrown vegetation, are the primary carriers of the disease," the statement said.

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What Is West Nile Fever?

The disease is spread through mosquito bites, and most who get infected do not have any symptoms. However, one in every five infected people has a fever, headache, body aches, and other flu-like symptoms.

The West Nile virus also infects the nervous system and is capable of causing serious brain or spinal cord inflammation.

According to the WHO, West Nile Virus is a member of the flavivirus genus and belongs to the Japanese encephalitis antigenic complex of the family Flaviviridae.

The mosquitoes become infected when they feed on birds that carry the virus in their blood, and then bite humans and infect them.

West Nile Fever: The Symptoms

The symptoms include fever, headache, muscle aches, nausea and vomiting, diarrhoea, rash around the chest and back, swollen lymph nodes, sore throats, and pain behind the eyes.

In severe cases, individuals may have an intense headache, high fever, stiff neck, making you unable to move your chin towards your chest, confusion, muscle weakness, loss of control over your muscle movements, seizures, paralysis, and coma.

West Nile Fever: How Does It Spread?

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While the mosquitoes that feed on infected birds are the carriers, there is still a lack of evidence to determine whether it comes directly from the birds. The incubation period for symptoms to show up is two to six days, but it can extend to 14 days, too.

It can be transmitted from a pregnant person to their fetus, through human milk, blood transfusion, and organ transplant. People who are over the age of 60, have cancer, diabetes, or high blood pressure are more prone to the virus.

West Nile Fever: Treatment

There are no treatments or antiviral medications available for it. However, one can treat the mild symptoms at home with over-the-counter medications that you take for a cold or the flu. The best way to prevent is to protect yourself from mosquito bites.

Dr. Ravi Vij, an Indian-origin cancer specialist and an alumnus of Maulana Azad Medical College in New Delhi, has been given the prestigious honor of a professorship for his contributions to advancing treatments for blood cancers.

He has been appointed as the inaugural Jeffrey S. and Prue H. Gershman Distinguished Professor in the John T. Milliken Department of Medicine at Washington University School of Medicine.

Vij is currently a professor of medicine in the department’s Division of Oncology. The professorship has been funded by St. Louis philanthropists Jeffrey and Prue Gershman, who support local education, health, and arts organizations.

In a statement, Chancellor Andrew D. Martin stated that this professorship, "will accelerate progress against blood cancers by supporting Dr. Vij’s work to bring new, more effective treatments to patients".

Martin also lauded Dr. Vij’s leadership, noting that it has "helped grow WashU Medicine’s reputation as a national force in stem cell transplantation and immunotherapy".

Leading Blood Cancer Research

Dr Vij's work includes studying the genetic underpinnings and cellular microenvironment of multiple myeloma — a cancer of the plasma cells in bone marrow.

He also treats patients at Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine, and is the principal investigator of the Multiple Myeloma Tissue Banking initiative at Siteman.

He has led several clinical trials of investigational therapies for blood cancers, including immunotherapy agents and novel stem cell transplant strategies, that later became standard treatments. He has authored more than 300 scientific publications in the field of blood cancers.

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Contributions Beyond Research

Beyond his research into blood cancer, Dr. Vij has served on the American Society of Clinical Oncology education and scientific committees and on the myeloma committees of the Clinical Trials Network and Alliance for Clinical Trials in Oncology.

He currently serves as senior editor of the journal Clinical Lymphoma, Myeloma and Leukemia and is a past chair of the American Society of Hematology scientific committee on plasma cell dyscrasias, a group of disorders linked to blood cancers.

His accolades include the Multiple Myeloma Research Foundation Innovator Award, the Center of Excellence Award, and the Leukemia & Lymphoma Society Visionary of the Year Award.

A respected educator, Vij has mentored 25 early-career researchers and received the Teacher of the Year Award from the Hematology and Oncology Fellowship Program at WashU Medicine in 2007.

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Education and Career

Dr. Vij completed his medical education at Maulana Azad Medical College in New Delhi, India, followed by postgraduate training at Halifax General Hospital and Royal Infirmary in the United Kingdom.

He completed an internal medicine residency at Rush University in Chicago and fellowships in medical oncology, hematology, and bone marrow transplantation at WashU Medicine. He joined the WashU Medicine faculty in 2000.

What Is Blood Cancer?

Blood cancer is broadly classified into three main types: leukemia, lymphoma, and myeloma. Leukemia is a cancer of the blood and bone marrow, while lymphoma affects the lymphatic system, particularly the lymph nodes and immune cells. Myeloma is a cancer of plasma cells found in the bone marrow.

These cancers disrupt normal blood cell function and can cause symptoms such as fatigue, infections, and unexplained bleeding.

Symptoms And Treatment

Common symptoms of blood cancer include:

• Persistent fatigue
• Frequent infections
• Unexplained bruising or bleeding
• Weight loss
• Swollen lymph nodes

The causes and risk factors for blood cancer vary. Genetic mutations, exposure to radiation or harmful chemicals, certain infections, and a family history of blood cancer are known risk factors. The risk of developing blood cancer generally increases with age.

Advanced treatment options for blood cancers include immunotherapies such as CAR-T cell therapy and stem cell transplantation.