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.
If left untreated, TTTS can have devastating consequences. Medical research indicates that:
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.
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.
Twin pregnancies, even without the presence of TTTS, entail a variety of health risks to the mother as well as infants:
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.
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.
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.
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.
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.
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.
Credit: iStock
The UK government has mandated that all schools across the country stock life-saving allergy pens from September under new statutory guidance known as Benedict's Law.
Published by the Department for Education (DfE), the guidance requires schools to keep adrenaline auto-injectors (AAIs), commonly known as allergy pens, on site. Teachers will also receive training to ensure they can respond quickly during emergencies, including administering the devices.
The nationwide rollout follows campaigning by the National Allergy Strategy Group and families, including Helen and Peter Blythe, parents of Benedict Blythe, who died after suffering an allergic reaction at school in 2021.
Under the new guidance, schools will also be expected to have clear allergy policies and healthcare plans, the DfE said.
"Today is a really important day for the thousands of families across the country who for too long have worried about keeping their children safe," said Education Minister Olivia Bailey.
"Benedict's Law means every single school will now have the training plans and the life-saving equipment in place to protect every child."
The statutory guidance, which sets out what schools must do to adhere to the law, will come into force in September.
From 2027, the same measures will become statutory duties and will apply to state schools, independent schools and fee-paying special schools. This means schools will be legally required to implement the changes.
Benedict Blythe died after accidental exposure to cow's milk protein while at Barnack Primary School, between Stamford and Peterborough, in December 2021.
Benedict was just 5 years old when he died following an allergic reaction at school.
On the morning of 1st December 2021, he opened his advent calendar and happily went off to class, a few hours later he collapsed and died from anaphylaxis. He was allergic to dairy, eggs, peanuts, sesame and chickpeas.
His mother, Helen Blythe, said she had worked with the school to put together an allergy action plan, but an inquest heard that process had not been followed.
"Had Benedict's Law and this guidance been in place when he'd been at school, he almost certainly would still be with us," Blythe said.
She noted that the Benedict's Law meant children would be "stepping into an education system far safer than the one that has come before," BBC reported.
She added there was a "significant gap" in schools' preparedness for children with allergies that would be addressed by Benedict's Law.
According to research by the Benedict Blythe Foundation, 50% of schools in England do not have any spare medication, one-third have no allergy policy, and 70% do not have all the measures now being introduced.
"The publication of this guidance is the beginning of a new era for allergy safety," Blythe said.
"It will improve the safety of hundreds of thousands of children and ensure around one and a half million adults working in schools have the knowledge and confidence to recognize an allergic reaction and respond quickly in an emergency."
The Mayo Clinic defines anaphylaxis as a sudden, severe, and potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you're allergic to, such as peanuts or bee stings.
Anaphylaxis causes the immune system to release a flood of chemicals that can cause you to go into shock — blood pressure drops suddenly and the airways narrow, blocking breathing.
Signs and symptoms include:
The first-line treatment for anaphylaxis is epinephrine (adrenaline), which is available by prescription as an auto-injector or nasal spray. It works by reversing the life-threatening symptoms of a severe allergic reaction.
Delays in using epinephrine are common in fatal food allergy reactions. Other medications, such as antihistamines, are not adequate substitutes because they do not reverse airway swelling or raise dangerously low blood pressure.
Allergists advise that everyone with food allergies carry their epinephrine delivery device at all times, particularly those who have previously experienced anaphylaxis, have both food allergies and asthma, or are allergic to peanuts, tree nuts, fish or crustacean shellfish.
Credit: AI generated image
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.
According to Dr Mario, the factors driving zoonotic spillovers are becoming more intense rather than diminishing. He pointed to:
"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.
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.
Read More: COVID-19 Vaccination Reduced Risk of Heart Attacks and Strokes in Elderly by 40%: Study
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.
READ: Australia Reports More H5 Bird Flu Cases: Does It Have Pandemic Potential?
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:
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.
Credit: AI
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).
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.
Also Read: Vagus Nerve Implant Shows Promise for Lasting Relief in Treatment-Resistant Depression: Study
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.
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.
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:
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.
Also read: Teplizumab: UK NHS To Roll Out World-First Drug To Delay Onset Of Type 1 Diabetes
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.
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:
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.
© 2024 Bennett, Coleman & Company Limited