Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

The UK today began the first phase of its flu vaccination program, offering jabs to millions of children and pregnant women ahead of winter.

Nearly 19 million people received their flu jab in England last year, helping prevent an estimated 104,000 hospitalizations.

Why Do Early Flu Vaccinations Matter?

Flu season typically peaks in December and January. Starting vaccinations earlier for children and pregnant women aims to protect those most vulnerable to serious illness and limit the spread of the virus before it circulates more widely.

Starting vaccination in September gives children and pregnant women time to build protection before flu begins circulating more widely. As per the NHS, the children’s flu vaccine can take up to 14 days to work.

Who Gets the Flu Jab First?

Children and pregnant women are among the first groups offered vaccination because they are more vulnerable to serious illness from flu.

Most school-aged children will receive their vaccine, via nasal spray, at school.

Parents of two- and three-year-olds, as well as children in clinical risk groups, will be invited to arrange vaccination through their GP practice.

Pregnant women can receive the flu jab at any stage of pregnancy through their maternity team, GP practice or participating pharmacy.

NHS teams are also taking vaccines into local communities, including through high street pharmacies and mobile vans.

Why Are Young Children and Pregnant Women More Vulnerable?

Flu can be much more serious than a bad cold. Every winter, thousands of children require hospital care because of the virus, while pregnant women also face a higher risk of serious illness.

Flu can spread quickly among younger age groups, which means vaccinating children can also help limit transmission to people who may be more vulnerable, including babies, grandparents and pregnant women.

Vaccinating pregnant women can also help protect their newborn babies in their first weeks.

“Flu can really knock you for six, and for some children and pregnant women it can mean becoming seriously ill or ending up in hospital. Getting vaccinated only takes a few minutes, but it can make a real difference – helping protect you and the people around you from getting seriously unwell,” said Dr Amanda Doyle, National Director for Primary Care and Community Services at NHS England.

When Will Other Groups Get Vaccinated?

From 1 October, flu vaccinations will be offered to other eligible groups, including:

• People aged 65 and over
• Adults with some long-term conditions
• Care home residents
• Carers
• Close contacts of people who are immunocompromised
• People experiencing homelessness
• Frontline health and social care workers

Parents of two- and three-year-olds will also be able to book appointments at participating community pharmacies through the National Booking Service from October.

NHS Expands RSV Vaccination Program

The NHS’s year-round RSV vaccination program is also expanding from today to include people aged 65 to 74 with a weakened immune system or certain long-term lung conditions.

RSV can make babies and adults with long-term lung conditions seriously unwell and increase their risk of hospitalisation.

Eligible people can receive the vaccine through their GP practice or, in some areas, a participating pharmacy. Those eligible should expect an invitation from their GP.

Pregnant women can also receive RSV, whooping cough and flu vaccines to help protect their newborn babies in their first weeks.

“Vaccinations play a vital role in protecting those most at risk from flu and they are also crucial for relieving pressures on our NHS over the winter months,” Secretary of State for Health and Social Care Yvette Cooper said.

“Everyone who is eligible for a free vaccination will be notified through their phone or in the post,” Cooper added.

A US woman has naturally conceived and given birth to a healthy set of triplets, a rare pregnancy that medical professionals described as an uncommon occurrence.

Nyla Craft from South Bay region in Los Angeles, already a mother of two — a daughter and a son — gave birth to three boys: two identical twins and a third who is their fraternal sibling, said chief of neonatology Dr Rohit Passi at Kaiser Permanente South Bay Medical Center, as reported by the Los Angeles Times.

“This is a very rare pregnancy and a rare outcome,” Passi said.

Triplets Conceived Naturally

The triplets were conceived naturally, Passi said, which happens in only about one in 10,000 pregnancies.

They were carried for 36 weeks, which is considered a good gestational period for triplets. All three were born at a healthy weight, with a combined weight of about 19 pounds — around three pounds short of the reported world record total weight for triplets, according to the Guinness Book of World Records.

Also read: Scottish Toddler With Rare UV Disorder Gets UV-Safe Home: All About Inherited XP

Pregnancy Was Physically Demanding

Craft said she first learned she was expecting triplets during a doctor’s appointment earlier this year.

“Earlier this year, I went to the doctor and I saw like two different sets,” she said. “I was like, oh my goodness, I’m having twins. And she was like, no, there are three. And I was like, oh my gosh, triplets.”

Craft said the physical demands of carrying the triplets were unlike anything she had experienced before.

When she learned the three babies weighed a combined 19 pounds at birth, the figure put her difficult pregnancy into perspective, ABC7.com reported.

Rare Combination Of Identical And Fraternal Twins

Quynh Vo-Hanser of Kaiser Permanente South Bay said the pregnancy was especially unusual.

“This is a really rare event,” Vo-Hanser said. “This is what we would refer to as a mixed triplet. This is a spontaneous pregnancy, which meant that it was achieved naturally. And within this triplet set, there’s an identical twin set, and then the fraternal sibling.”

Vo-Hanser emphasized the rarity of the birth. “Within the United States, there are 3.5 million deliveries and about 2,400 are triplets,” she said.

Hospital Assembled Larger Delivery Team

Read More: Fournier Gangrene: Woman Develops Rare Flesh-eating Infection After Bikini Shave, Herbal Application

The rare delivery on August 18 required a larger-than-usual medical team to care for both the mother and the three babies.

There were three NICU nurses, one for each baby, along with two doctors caring for the babies and additional doctors and nurses looking after Craft. “There were about 15 people in the delivery room when we normally have about five,” Passi said.

Triplets Came Close To Reported World Record

The trio’s combined birth weight of about 19 pounds also put them close to the reported world record for the heaviest set of triplets at birth, which stands at 22.7 pounds.

The combination of a naturally conceived triplet pregnancy, an identical twin pair and a fraternal sibling, all born at 36 weeks and of the same sex, made the delivery particularly unusual, according to the medical team.

A fever in an infant or young child is often dismissed as a routine infection. However, recurrent or unexplained fever could sometimes point to a urinary tract infection (UTI), which, when associated with an underlying abnormality, may put the kidneys at risk. Identifying UTIs early is particularly important in infants and toddlers who cannot communicate their symptoms.

When Fever May Signal a UTI

Unlike older children, infants and toddlers cannot explain symptoms such as pain or burning while urinating. A UTI may therefore present only as fever, poor feeding, reduced milk intake or irritability.

Whenever a child has a febrile UTI, we should look for an underlying cause. One such condition is vesicoureteral reflux (VUR), where urine flows backwards from the bladder towards the kidneys.

How Reflux Can Affect the Kidneys

When bacteria are present in the bladder, this backward flow can carry infection towards the kidneys. Repeated kidney infections can cause renal scarring, particularly in young children.

Repeated scarring can affect kidney growth and function and, in severe cases, contribute to chronic kidney disease later in life. This makes timely evaluation and management important.

Also read: No Washrooms for Women: The Shocking Health Risks of UTI, Hyperuricemia & More

Not Every Child Needs Surgery

After a documented febrile UTI has been treated, children may require evaluation for an underlying cause based on their age, history and clinical findings. If VUR is identified, treatment depends on its severity. Not every child with reflux needs an operation. Management depends on the grade of reflux and the child’s clinical condition.

VUR is graded from 1 to 5. Low-grade reflux, particularly Grades 1 and 2, can often be managed through monitoring and, in selected cases, antibiotic prophylaxis. Many children may outgrow the condition as the urinary system matures.

Higher-grade reflux, especially when associated with recurrent infections or renal scarring, may require intervention. Options include minimally invasive Deflux injection or laparoscopic and robotic-assisted surgery in selected cases.

Also read: AIIMS Performs Second Dual Kidney Transplant Using Organs From 70-Year-Old Donor: How It Can Expand Donor Pool?

Prevention Goes Beyond Antibiotics

Constipation, bowel and bladder dysfunction, and improper toilet habits, which can contribute to recurrent UTIs, should also be given attention. Encouraging children to void regularly and managing constipation can help reduce infections.

In the present era, urinary abnormalities may be suspected during an antenatal ultrasound (TIFFA scan) allowing early postnatal evaluation and monitoring.

Early Detection Can Protect Kidney Health

The message for parents is simple: recurrent fever in a young child should not always be dismissed as a routine infection. Identifying a UTI and investigating an underlying problem such as VUR at the right time can help prevent recurrent infections, reduce renal scarring and protect kidney health in the long run.

By Dr. G. Ravindra Varma, Managing Director and Senior Consultant Urologist, Andrologist, Uro-Oncologist, Laparoscopic and Robotic Surgeon, AINU, Visakhapatnam