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.

Delhi's air quality has slipped into the 'poor' category for the first time in more than 85 days, even as the monsoon season sets in. While rainfall is often expected to clear the air, doctors warn that a combination of lingering pollution, high humidity, mold, allergens, and seasonal viral infections can significantly increase the risk of respiratory illnesses in children. Experts say children are especially vulnerable because their lungs and immune systems are still developing, making it easier for polluted air and environmental triggers to affect their breathing and long-term lung health.

After weeks of relatively clean air, Delhi's air quality deteriorated sharply on July 12, with the city's overall Air Quality Index (AQI) slipping into the 'poor' category at 261—the highest level recorded in more than 85 days.

According to Central Pollution Control Board (CPCB) data, this was the city's highest AQI since April 17, when it stood at 263.

Repeated exposure to polluted air during childhood can impair lung development and increase the risk of long-term respiratory diseases.

"Air pollution affects children more because their lungs are still developing, and they breathe faster than adults, inhaling more polluted air relative to their body weight," Dr. Narendra Kumar Jha, Director and Head of Pediatrics at Yashoda Medicity, told HealthandMe.

He added that inhaled pollutants irritate and inflame the airways, weakening the body's natural defense mechanisms. This can lead to chronic cough, wheezing, breathing difficulties, throat irritation, and worsening of conditions such as asthma and allergic rhinitis.

Why Children Are More Vulnerable

Children are not simply "small adults," said Dr. Nikhil Rajvanshi, Consultant, Pediatric Pulmonology, Madhukar Rainbow Children's Hospital, Delhi.

Because their lungs and immune systems are still developing, children breathe faster and inhale more air per kilogram of body weight than adults, making them more susceptible to pollution, infections, and environmental triggers.

How Air Pollution Affects Children's Lungs

According to Dr. Rajvanshi, pollutants such as PM2.5, PM10, nitrogen dioxide, and ozone penetrate deep into the lungs, triggering inflammation.

Even short-term exposure can cause:

• Coughing
• Wheezing
• Chest tightness
• Reduced exercise tolerance
• Increased emergency visits in susceptible children

Over time, repeated exposure can impair lung growth, reduce lung function, worsen asthma control, and increase the risk of chronic respiratory diseases later in life.

Why Respiratory Illnesses Increase During the Monsoon

Despite occasional rainfall clearing pollutants, the monsoon creates conditions that favor respiratory illnesses.

Dr. Rajvanshi explained that high humidity promotes indoor mold growth, damp conditions increase exposure to fungal spores, viral infections spread more easily, and sudden weather changes can trigger asthma. Periods of stagnant air between rainfall spells may also allow pollutants to accumulate.

As a result, pediatric clinics are reporting more cases of:

• Viral upper respiratory tract infections
• Persistent cough after viral illness
• Wheezing, especially in preschool-aged children
• Acute asthma attacks
• Allergic rhinitis with nasal blockage and sneezing
• Breathing difficulties linked to humidity, mold exposure, and fluctuating air quality

Children with asthma or allergies are particularly vulnerable, as viral infections combined with poor air quality can significantly worsen their symptoms.

How Parents Can Protect Their Children

Dr. Jha advised parents not to ignore persistent cough, breathing difficulty, or sleep disturbances caused by respiratory symptoms.

On days when pollution levels are high, children should avoid prolonged outdoor activities and strenuous exercise. Parents should also keep indoor air as clean as possible, ensure children stay hydrated, and continue prescribed asthma medications if needed.

Other preventive measures include:

• Monitor the daily AQI before outdoor activities.
• Keep children away from tobacco smoke, incense, mosquito coils, and indoor biomass smoke.
• Prevent dampness and mold inside the home.
• Clean regularly to reduce dust accumulation.
• Encourage frequent hand hygiene.
• Ensure adequate sleep, hydration, and a balanced diet.
• Continue prescribed controller medication and maintain an updated asthma action plan for children with asthma.
• Ensure eligible children, particularly those with chronic respiratory diseases, receive an annual influenza vaccination.

When Should Parents Seek Medical Care?

Parents should consult a pediatrician if a child develops:

• Fast or difficult breathing
• Wheezing or noisy breathing
• A cough lasting longer than two to three weeks
• Recurrent nighttime coughing
• Fever accompanied by breathing difficulty
• Poor feeding or lethargy in infants
• Bluish lips or fingertips
• Asthma symptoms that do not improve with prescribed reliever medication

Dr. Rajvanshi stressed that early medical evaluation can help distinguish between viral infections, asthma, allergies, pneumonia, and other lung conditions.

"Not every cough requires antibiotics, and not every episode of wheezing means a child has asthma. However, recurrent cough, persistent wheezing, exercise limitation, or breathing difficulty should never be ignored. Early diagnosis and appropriate treatment can prevent complications and improve long-term lung health," he told HealthandMe.

The adolescent stage is a crucial milestone in one’s life due to various developments experienced by teenagers at this stage. Adolescents must get access to comprehensive reproductive health education because it is instrumental in educating them on various health concerns, enabling them to develop healthy lifestyles.

Nonetheless, due to social taboos, myths, and insufficient information, adolescents find themselves in a situation where they are not conversant with health concerns.

Creating Awareness About PCOS and Menstrual Health

Among some of the things that need to be discussed in relation to adolescent reproductive health is the issue of Polycystic Ovary Syndrome (PCOS) and menstruation. Today, there is a higher prevalence of PCOS among girls and young women than before, which is related to various complications, including irregular menstruation, acne, excess body hair, and obesity problems in the future. It is important to know the first signs of PCOS to make a quick diagnosis of the disease and bring about lifestyle changes.

Another aspect that should be taken into account is the promotion of menstrual hygiene among girls. Girls need to understand that menstruation is a natural phenomenon that, therefore, nothing should prevent them from practicing good menstrual hygiene practices, including the use of sanitary products and appropriate methods of changing their pads.

The Importance Of HPV Vaccination

Reproductive health education must include HPV vaccination information, which would be the most effective way to prevent cervical cancer. HPV vaccination is something that many parents and young people don't know much about, including its benefits and recommended vaccination age. Therefore, educating people about how important it is to be vaccinated against HPV will help reduce the occurrence of cervical cancer in the future.

Encouraging Responsible Reproductive Health

The responsibilities regarding reproductive health also refer to the understanding of the process of puberty, but additionally include educating young people with regard to responsible behavior, respecting limits, practicing consent, and the importance of making informed decisions.

Building a Healthier Generation

Educating teenagers is very important in order to have a healthy generation in the future. Everybody should work together to create a supportive environment that encourages discussions regarding reproductive health problems. The promotion of awareness regarding PCOS, HPV vaccinations, and other reproductive health problems would also enable our children to become proactive in taking care of their health.

(Dr. Priya Gupta, Senior Consultant - Obstetrics and Gynecology, Cocoon Hospital, Jaipur)

Pregnancy is often considered to be a journey that begins with a positive pregnancy test. But medical experts agree that the foundation of a healthy pregnancy is laid much earlier, through preconception care, and strengthened throughout pregnancy with consistent antenatal care. The two stages together are important for the health and well-being of both mother and baby.

Preparing for Parenthood Before Conception (Preconception Care): Why it's important.

Preconception care is the care that happens before a woman becomes pregnant. It involves identifying and managing medical, nutritional and lifestyle factors that may affect pregnancy outcomes. If you’re planning a pregnancy or thinking about getting pregnant in the near future, it’s a good idea to prepare your body in advance to help lower the risk of complications. This is especially important considering that 40–50% of pregnancies worldwide are estimated to be unintended, according to the World Health Organization (WHO).

A preconception health check-up will usually include a review of your medical history, screening for chronic conditions such as diabetes, hypertension, thyroid disorders and anemia, assessment of your vaccination status and discussion of any medications that may not be safe during pregnancy. Doctors also advise women to start taking folic acid supplements at least a month before they conceive to help prevent neural tube defects in the developing baby.

And the healthy lifestyle choices are equally important. Maintaining an ideal weight, following a balanced diet, engaging in regular physical activity, avoiding tobacco and alcohol, and managing stress can improve fertility and contribute to a healthier pregnancy.

Every Check-Up Counts (Antenatal care)

Antenatal care should be routine once pregnancy is confirmed. These regular medical visits allow healthcare providers to monitor the growth and development of the baby and watch the mother’s physical and emotional health. WHO recommends at least 8 antenatal contacts. The guideline was increased from four visits to eight contacts during pregnancy to improve maternal and newborn outcomes and reduce preventable stillbirths.

Blood pressure, weight, blood and urine tests, ultrasound scans and fetal growth are regularly checked during routine antenatal appointments. These tests help to identify potential problems such as gestational diabetes, preeclampsia, anemia, or restrictions in fetal growth early on so that treatments can be given in a timely manner.

Antenatal care also gives valuable advice on nutrition, exercise, sleep, mental well-being, breastfeeding preparation and identifying warning signs that require immediate medical attention. Most importantly, it reassures expectant parents and helps to address concerns throughout pregnancy.

Pregnancy care is not just the expectant mother's responsibility. Partners and families can play an important role in providing a supportive environment, encouraging healthy habits, attending medical appointments when able, and providing emotional support. Having a supportive system can help to lower stress levels and improve maternal mental health, which can contribute to better pregnancy outcomes.

As awareness grows, health care providers are encouraging couples to think beyond the baby bump and prioritize health even before pregnancy begins. With advance planning, regular medical care, fact-based lifestyle choices and prompt treatment, when necessary, you can make a real difference and help ensure that pregnancy is a safer and healthier experience for mother and child.

(Dr. Roli Banthia, Consultant- Obstetrics and Gynaecology, Yatharth Super Speciality Hospital, Noida Extension)