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.

Even after recovery, the deadly Ebola virus (EBOV) can persist for a longer duration — more than three months — in breastmilk, according to a case report.

Ebola virus disease (EVD) is a severe viral illness that has a 25 percent – 90 percent fatality rate.

Ebola in pregnancy raises significant complications ranging from spontaneous abortion to maternal and neonatal death.

In a case report published in the New England Journal of Medicine, a team of researchers from the Republic of Congo and Senegal shared the case history of a 23-year-old woman in whom Ebola was still detectable in breast milk at 14 weeks.

The case reported the rare occurrence of a pregnant woman who survived EVD with no complications, neither to the mother nor the baby. However, the deadly virus was still present in the mothers' breast milk, which cited the potential risk of post-illness transmission to infants.

What Is Ebola Virus Disease?

As per the World Health Organization (WHO), EVD is a rare but severe illness in humans and is often fatal.

People can get infected with the virus if they touch an infected animal when preparing food, or touch body fluids of an infected person such as saliva, urine, feces or semen, or things that have body fluids of an infected person like clothes or sheets.

Ebola enters the body through cuts in the skin or when one is touching their eyes, nose or mouth. Early symptoms include fever, fatigue and headache.

What Was The Case

The woman from the Democratic Republic of the Congo (DRC) contracted EBOV during pregnancy in 2019.

Soon after, she was administered monoclonal antibody therapy and was discharged after three negative reverse-transcriptase–polymerase-chain-reaction blood tests for EBOV.

The woman delivered a healthy baby at 42 weeks of gestation. No evidence of EBOV infection was found in maternal blood, amniotic fluid, vaginal secretions, or the newborn.

Ebola Detectable In Breast Milk At 14 Weeks

Yet surprisingly, the EBOV virus persisted in the placenta and breast milk.

Tests revealed that while the mother’s blood remained negative, viral RNA was still detectable in breast milk at 14 weeks after illness onset. To protect the newborn from transmission, clinicians used the drug bromocriptine to suppress lactation.

As per the World Health Organization (WHO) guidelines, the mother was also isolated from the baby and not breastfed. A prophylactic (preventive) monoclonal antibody was also given to the newborn. During follow-up, the infant exhibited no signs of infection.

Ebola Virus: WHO Guidelines

During the 2018–2020 EVD outbreak in the northeast of DRC, 3,481 confirmed cases were reported. Of these, nearly 60 percent occurred in females, and about 45 percent occurred in children below 18 years of age.

Current WHO guidance recommends that Ebola survivors avoid breastfeeding until viral clearance is confirmed.

The global health body advises women with suspected or confirmed Ebola to immediately stop breastfeeding and be prioritized for diagnostic testing.

Children exposed to Ebola through breast milk

• Must be placed under care,
• Closely monitored for symptoms over 21 days
• Fed with an appropriate breast milk substitute.
• Restarted on breastfeeding after two consecutive negative tests of breast milk.

Meningitis – the inflammation of the brain and spinal cord lining – has claimed 259,000 lives worldwide in 2023, according to a new study, published in The Lancet Neurology.

A total of 2.5 million people globally were infected with meningitis, which is also the leading infectious cause of neurological disabilities.

Importantly, children accounted for a third of the deaths, many of which were in Africa, according to research that described itself as the most comprehensive global assessment of meningitis yet.

The study comes amidst a “unprecedented” meningitis outbreak in the UK’s Kent, where two people died, and many were infected.

Meningitis: Achieving WHO 2030 goals

According to the study, global vaccination campaigns since 2000, played a significant role in reducing the number of infections and deaths by bacterial meningitis, in both high-income and low-income countries.

The Global Burden of Disease study led by an international team of researchers led by those from the University of Washington, showed that although mortality and incidence have declined significantly since 1990, progress is insufficient to meet the WHO 2030 targets.

The WHO targets a 50 percent reduction in meningitis infections and 70 percent reduction in deaths by 2030. However, a substantial meningitis burden persists. It also lags behind other vaccine-preventable diseases.

The driving factor are:

• common pathogens such as S pneumoniae and N meningitidis
• emerging non-bacterial pathogens such as Candida spp
• drug-resistant fungi.

Also read: Bacterial Meningitis May Cause Long-term Fatigue, Vision Problems, Raise Suicide Risk: Study

What Is Meningitis?

Meningitis is a serious medical condition that affects the protective membranes covering the brain and spinal cord, the meninges. While fever is not always present, it is usually considered as one of the classic symptoms of meningitis.

It is important to know the varied symptoms, causes, and treatments of meningitis for early diagnosis and proper management of the disease.

Meningitis is an infectious illness that brings about inflammation in the meninges. The most common cause of such inflammation is bacterial or viral infections, though other causes are also possible including fungal, parasitic, or non-infectious causes (autoimmune disease, head injury, or brain surgery).

Meningitis may also be caused by bacterial meningitis, which the Centers for Disease Control and Prevention (CDC) indicates can be so severe and bring about conditions like hearing loss, vision problems, and death if not received on time.

Also read: From Vaping to Worm Attack: 5 Unimaginable Ways to Contract Meningitis

Meningitis: Risk factors

As per the Lancet study, the greatest risk factors for deaths was

• low birthweight
• premature birth
• air pollution (both household and atmospheric).

Streptococcus pneumoniae, Neisseria meningitidis, non-polio enteroviruses, and other viruses were the leading causes of death, while non-polio enteroviruses caused the most cases.

To achieve further reductions in the disease globally, the researchers called for greater efforts, including:

• expanding vaccination programs,
• greater antibiotic stewardship,
• improving access to care,
• strengthening diagnostics and monitoring for meningitis.

Also read: Unique Symptoms Of Meningitis That Caused An Outbreak In Kent University

Common Symptoms Of Meningitis

• Rash
• Headaches
• Neck stiffness
• Fever
• Drowsiness
• Nausea or vomiting
• Increased sensitivity to light.

World Doctors’ Day is celebrated every year on March 30 to honor physicians for their dedication and compassion in saving lives and ensuring healthy communities.

Doctors are often regarded as God as they work tirelessly to save lives, even amidst conflicts or pandemics, without counting their own lives.

Often referred to as a noble profession, their mission transcends boundaries and also showcases profound human values rooted in compassion, dedication, and responsibility.

They play a significant role in building resilient, healthy societies and the world.

While there is no universally declared theme to mark the day, several campaigns are held focusing on the well-being and resilience of doctors, especially in the post-pandemic era.

World Doctors’ Day: History

World Doctors’ Day is the same as US National Doctors Day.

It was first observed in 1933 in Georgia and officially recognized in 1990 when George H. W. Bush signed it into law.

The first Doctors' Day was initiated by Eudora Brown Almond, wife of Dr. Charles B. Almond, and was adopted by the Barrow County Alliance.

The day was also observed to mark the anniversary of the first use of general anesthesia in surgery by Dr. Crawford W. Long in Jefferson, Georgia, in 1842.

The idea was then presented to the Georgia State Medical Alliance in 1933 by E. R. Harris of Winder, president of the Barrow County Alliance.

On May 10, 1934, the resolution was adopted at the annual state meeting in Augusta, Georgia.

Later, it was resolved by the Senate and House of Representatives of the US in Congress to designate March 30 as “National Doctors’ Day.”

The symbol for Doctors' Day is often the red carnation, chosen for its color that represents love, charity, and sacrifice — that highlights the profession.

The US reportedly has over 985,000 to 1 million practicing physicians.

World Doctors’ Day: Significance:

The day honors physicians' commitment, service, and contributions to healthcare, often highlighting their role in patient care. Their role is also in medical innovations that have given life to people across the globe.

It also highlights challenges faced by the physician community, like burnout, workforce shortages, and rising health demands.

Doctors are also overburdened with increasing patient load and staff shortages. Some also face workplace violence and safety concerns.

Notably, digital healthcare and evolving technologies have also added pressures and an additional burden to their practice.

Countries Celebrating World Doctors’ Day

World Doctors’ Day is celebrated on March 30 in the US, the UAE, and Australia.

India celebrates National Doctors’ Day on July 1, commemorating the birth and death anniversary of renowned physician Dr. Bidhan Chandra Roy.