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.

At the Times Network India Health Summit 2026, Dr. Deepak Kumar, Professor and Head of the Department of Psychiatry at the Institute of Human Behaviour and Allied Sciences (IHBAS) said that suicidal thoughts should be treated as a medical emergency requiring immediate professional help, just as in cardiac emergencies.

He said, “A death wish is usually a cry for help. Just as we provide immediate medical care during cardiac emergencies, suicide risk also requires urgent medical attention.”

Speaking during a session titled “The Next Frontier in Indian Psychiatry: Specialization, Geriatric Mental Health, and De-addiction Strategies”, Dr. Kumar discussed the importance of recognising early warning signs and monitoring screen time in children to prevent serious mental health disorders.

Dr. Kumar stressed that suicidal thoughts or a wish to die should never be treated casually as they could be silent cries for help.

"It is a very good thing to give space to mind and mental health in a health conclave. If we look at the numbers in our country, the total proportion is alarming. For example, the national mental health survey shows a lifetime prevalence of 13.7%. One in every 5 people has some psychological issue. Suicide statistics show 12 per lakh. Top 3 causes of death in young adults - one of them is suicide."

Excessive Screen Time Can Affect Children's Mental Health

While discussing smartphones and social media, Dr. Kumar said excessive screen use can interfere with daily functioning as one could be hooked on instant dopamine hit.

He spoke about gaming addiction disorders and said that such problematic smartphone use and excessive screen exposure are forms of behavioural addiction.

He said, “I will not advocate a blanket ban on smartphones like in Australia as they can also support education and learning.”

He advocated for judicious use among children and more awareness among parents to prevent excessive screen exposure.

Also read: Children’s Mental Health In The Digital Age: Can Governments Protect Them Without Restricting Internet Access? | Interview

Why Parents Should Set Screen-Time Limits

Dr. Kumar expressed concern about parents giving smartphones to very young children. He also recommended avoiding screen time for children under two and limiting use among older children.

He also said that Parents should pay attention to changes in children's sleep, mood, social interactions and everyday activities. He said looking out for signs like social withdrawal, distress or other behavioural changes should be priority.

Behavioural Changes Can Be Mental Health Concerns

According to Dr. Kumar, psychiatric conditions are often identified through symptoms and changes in a person's thoughts, emotions and behaviour, rather than through blood tests or imaging alone.

Diagnosis depends on the nature, duration and severity of symptoms, as well as their effect on everyday functioning, relationships and family or social life.

A sudden change in behaviour can be a warning sign. Someone who is usually cheerful, for instance, may become withdrawn, gloomy or reluctant to leave their room. Constant mood changes, behavioural outbursts and changes associated with substance use may also warrant attention.

Physical conditions can affect mental well-being, too. Dr. Kumar cited thyroid disorders and diabetes as examples of conditions that may be associated with depression or anxiety.

When Emily Hughes saw that her 18-month-old daughter, Scarlett, had a swollen knee in late 2023, she initially thought it might be an injury from the toddler’s routine playtime. Scarlett was energetic and adventurous, and the swelling did not appear to cause her pain.

But the swelling did not improve, and further examinations eventually led to a diagnosis of juvenile idiopathic arthritis (JIA), a chronic inflammatory condition that affects children.

Hughes, who lives in Australia, told Mamamia that several doctors initially found no cause behind her daughter’s symptoms. The situation changed in February 2024, when Scarlett’s knee became hot, painful and more severely swollen. She could no longer bear weight on the affected leg. “She wouldn’t bear weight, and it was even more swollen,” Hughes said.

Scarlett was taken to the Royal Children’s Hospital in Melbourne, where doctors initially thought it was septic arthritis, a serious joint infection. Investigations failed but the family continued consulting specialists.

By May, after other possible explanations got investigated, Scarlett was referred to a rheumatologist and diagnosed with juvenile arthritis affecting three joints.

Now four years old, Scarlett is in remission and has returned to physical activities like climbing and doing cartwheels. Her experience highlights why stubborn joint swelling and changes in a young child’s movement deserve emergency medical attention, even when the child is not in pain.

What Is Juvenile Idiopathic Arthritis?

Also read: Women And Arthritis: Why Risk Increases After 40

Juvenile idiopathic arthritis is the most common form of chronic arthritis in children. It refers to a group of several conditions in which the immune system triggers inflammation in the joints by mistake. Although genetic and environmental factors may contribute, the exact cause is unknown.

The condition can affect children younger than 16 and may involve one or several joints. The knees, ankles, wrists and elbows are commonly affected.

Unlike arthritis, JIA can begin during toddlerhood. Its symptoms may also be difficult to recognise as young children cannot always describe pain, stiffness or discomfort accurately.

There is no single test that confirms JIA. Doctors start by assessing the child’s symptoms, medical history and physical examination, and may use blood tests and imaging to investigate inflammation and rule out other conditions.

Signs Of Juvenile Arthritis Parents Should Not Ignore

Also read: Arthritis Day: Stanford Researchers Explore Possibility To Treat Osteoarthritis Without Knee Replacement Surgery

According to the US National Institute of Arthritis and Musculoskeletal and Skin Diseases and the American Academy of Pediatrics, parents should watch for the following symptoms:

1. Continued joint swelling

A knee, ankle, wrist or other joint that remains swollen should be assessed on priority. In JIA, painless swelling may occur even when the child seems comfortable.

2. Morning stiffness

Children may struggle to move a joint after waking up or after sitting still for a long time. Stiffness may improve as they become more active during the day.

3. Limping or reluctance to walk

A toddler who starts limping, avoids putting weight on one leg or has difficulty walking may be experiencing joint inflammation.

4. Difficulty bending or straightening a joint

Limited movement is also one of the signs. A child may struggle to straighten an elbow, bend a knee or move a limb as freely as before.

5. Changes in play and everyday activities

A child who suddenly avoids climbing, running or playing, or struggles with activities they previously dud easily, may have pain or stiffness.

Some children with JIA may also experience fatigue, fever, rash or reduced appetite, depending on the type of disease. Untreated inflammation can damage joints and interfere with a child’s movement and development. Early diagnosis and treatment aim to control inflammation, maintain joint function and help children maintain their usual activities.

JIA can also affect the eyes. Some children develop uveitis, inflammation inside the eye that may cause no obvious symptoms initially but can threaten vision if left untreated. Regular eye examinations are therefore an important part of JIA.

For every woman pregnancy is a beautiful and dream journey, but from the perspective of heart-health , it acts as a “natural stress test” for the body. The best part is most women recover completely after childbirth. However, certain complications such as preeclampsia, high blood pressure, gestational diabetes, preterm delivery, or poor fetal growth can sometimes be early warning signs of future cardiovascular risk.

As a cardiologist, I want women to know that preeclampsia does not simply end when pregnancy ends. It can signal a higher risk of high blood pressure, diabetes, heart disease and stroke later in life. Gestational diabetes also increases future cardiometabolic risk.

This does not mean you will develop heart disease. It means you have an opportunity to be proactive.

Also read: Maternal Immunisation: The Forgotten Half of Protecting a Baby's Health

What should be your postpartum action plan?

1. Check your blood pressure regularly, especially after preeclampsia or gestational hypertension.

2. Check blood sugar after gestational diabetes and continue recommended long-term screening.

3. Know your numbers: monitor cholesterol, weight and other cardiovascular risk factors.

4. Rebuild healthy habits: gradually return to regular exercise, eat a heart-healthy diet, avoid smoking and prioritise sleep.

5. Tell your doctor your pregnancy history—it is an important part of your lifelong heart history.

Your pregnancy may be over, but not your heart health journey, it continues for life time. Early awareness gives you the power to prevent problems before they begin.

By Dr. Sunil Kumar Mandal, MBBS, MD , DM (Cardiology), Senior Consultant Interventional Cardiologist