The world-first Twins Trust Centre for Research and Clinical Excellence, based at St George’s Fetal Medicine Unit, is celebrating its one-year anniversary.
The centre, which is a collaboration between St George’s and Twins Trust, opened last July and was set up to support maternity units throughout the UK.
The team are carrying out vital research to improve the outcomes of multiple pregnancies, and have developed a national education programme for healthcare professionals to share learning.
St George’s Fetal Medicine Unit has exemplary standards of care for families expecting twins, triplets or more and recent research has shown a 70% reduction in stillbirth after introducing the NICE multiple birth guidance.
The centre holds the world’s only multiple pregnancy registry, which gathers information from hospitals to help build a picture of multiple birth complications and their treatments to better analyse the link between management and outcomes.
Since the centre launched, the team has published seven pieces of research and two opinion papers on twins, triplets and more. The research aims for a better understanding of what families face so medics can improve future treatment and care.
As a result of the pandemic, the centre adapted its plans for in-person study days and instead created a series of 17 online webinars with Professor Khalil, clinical lead at the Twins Trust Centre of Research and Clinical Excellence. These were a huge success attracting more than 1,500 healthcare professionals, exceeding the original target of 120.
Professor Asma Khalil, Consultant Obstetrician and Multiple Birth Lead at St George’s said: “As one of the UK’s leading fetal medicine units, we are committed to making the UK one of the best and safest places for women expecting twins, triplets or more.
“Despite the challenging year we have all faced, the centre has already achieved so much, with seven research papers published and a series of successful educational webinars held for healthcare professionals across the UK.
“We are looking forward to the next twelve months and progressing our vital research to improve the outcomes of multiple pregnancies and save babies’ lives.”
Research means we can have a better understanding of what families face and improve treatment and care for the future. Here’s Nichola and Pete’s story.
Nichola and Pete’s story
“Asma saved our babies’ lives, there’s no doubt about that,” says Nichola Luther whose twin boys were born on April 4 2020, at the start of the Covid-19 pandemic.
Nichola and husband Pete were thrilled to discover they were having twins, two little brothers for their son Sebastian.
But at 18 weeks a scan picked up a 22% difference in the twins’ sizes and two weeks later a 29% difference. After a further scan at 24 weeks, their consultant at Southampton Hospital referred them to St George’s.
“This was the first time we met Professor Asma Khalil who diagnosed the twins with TAPS,” said Nichola.
TAPS is an uncommon condition that occurs in 3-5% of identical twin pregnancies. It occurs when small blood vessels form in the placenta between the babies, allowing a slow passage of blood from one baby to the other.
This results in one twin becoming very anaemic (very low blood count) and the other polycythaemic (very high blood count). This can lead to extra strain on the heart in both babies, which can make one or both babies unwell and can even be fatal in some circumstances.
“Asma was very calm and reassuring, speaking to us about options but at this point one of the twins, Asher, was showing signs of cardiac distress so we had to be quick with our decision,” said Nichola.
“As TAPS is so rare there is not much evidence on outcomes but we knew we had to have the laser surgery or lose one or possibly both babies.”
Nichola underwent a fetoscopic laser procedure to treat her babies. This involved inserting a camera into the womb, then using a laser to seal off the blood vessels that had been allowing blood to leak from one baby to the other.
After the successful laser surgery, Nichola was advised to stay home and try to keep the babies in for as long as possible. She was closely monitored, only leaving the house for scans and check-ups, but at 28 weeks her waters broke.
Nichola was examined and a decision was made for her to stay in hospital. A few days later, at 29 weeks Nichola’s twins were born via emergency c-section.
Asher weighed 2lbs10 and Leo 1lb15. They spent just under four weeks in the neonatal unit at Southampton Hospital before being moved to the special care baby unit at the hospital on the Isle of Wight.
Nichola is passionate about raising awareness of TAPS and also wants mums to be reassured by her story.
“TAPS really is incredibly rare and I hope that across the country fetal medicine teams, as well as all health practitioners who deal with multiple births, will continue to learn more about the condition through the excellent work of Asma and her team at the centre which will lead to saving more babies like Asher and Leo.
“With a simple test TAPS can be detected, but it’s not routine. We were lucky as we were in the right knowledgeable hands but lots of babies still aren’t, due to the syndrome being relatively new and lack of education on the subject. Asma and her team will help change this. Thank you Asma for saving our babies, we will be forever grateful.”
