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.

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.

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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

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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

We have often linked screen time with poor outcomes, especially when it comes to children's brain health. But a new Finnish study has learnt that children who spent more time on screens from childhood through adolescence tended to show better cognitive processing as teenagers.

The findings are based on an eight-year follow-up of the Physical Activity and Nutrition in Children (PANIC) study. It challenges the commonly believed idea of screen time being automatically harmful to children's developing brains.

The study was conducted by researchers from the University of Jyväskylä and the University of Eastern Finland and published in Pediatric Exercise Science.

However, researchers also emphasise that that the findings do not mean that children should simply spend more time on phones, tablets, or computers. What children are doing during that screen time may be more important than the number of hours alone.

Children With More Screen Time Performed Better On Cognitive Tests

The study is based on 260 adolescents composed of 124 girls and 136 boys, with an average age of 15.8 years. Researchers followed their physical activity, sedentary behaviour and screen use over a period of eight years. At the end of the study, the researchers examined learning, attention, and working memory.

They found that greater cumulative screen time from childhood into adolescence was associated with better cognitive processing during adolescence. Despite the suspected correlation, researchers did not establish that screen use itself improved children's cognitive abilities.

That distinction is important because the study was merely observational. It just identified a relationship between screen time and cognitive performance but could not prove cause and effect.

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Researchers Say What Children Do On Screens May Matter More

Petri Jalanko, a doctoral researcher at the University of Jyväskylä and first author of the study, said the findings suggest that screen use should not automatically be viewed as harmful. “The findings suggest that screen time can support children’s and adolescents’ cognitive processing.”

He said the type of activity children engage in could be an important factor. “Teachers and parents should encourage children to use devices and screens in such ways that promote active thinking, problem-solving, creativity and learning.”

This could include activities like educational games, creating digital content, researching topics, coding, solving problems, or using technology for learning rather than passive consumption.

Also read: Diabetics Must Undergo Retinal Screening To Protect Eye Health: AIIMS Doctors

Not A Free Pass For Unlimited Screen Time

The findings should not be interpreted as evidence that more screen time is always better. Researchers did not determine an ideal number of hours children should spend on devices. They also did not show that watching videos or scrolling social media for longer periods directly improves cognition.

Instead, the study reinforced the idea that “screen time” is not one single behaviour. A child using a tablet to solve a mathematics problem is doing something very different from a child spending hours passively scrolling through short-form videos.

Jalanko said, “We should not regard screen time solely as harmful but seek balance between physical activity and screen time that promotes active thinking.”

Eero Haapala, senior researcher in the study, and Jalanko emphasised that the relationship between physical activity, sedentary behaviour and cognition is complex.

Haapala said, “Our study indicates that the connections of physical activity and sedentary behaviour to cognitive processing are complex and depend on the sex, the type and assessment method of physical activity and sedentary time.”