Ugandan doctors separate dead conjoined twin from sibling

Doctors at Uganda's Soroti Regional Referral Hospital last Friday successfully separated a dead conjoined twin from a live sibling.

The twins had last Saturday been delivered by caesarean section at Amuria Health Centre IV in Amuria District but one was born still.

The babies whose bodies were attached by the stomach belonged to Ms Loyce Alinga, a resident of Aojangor village, Obalanga Sub-county in Kapelebyong District.

Ms Alinga, a Senior Three student, is among the many others who got pregnant during the Covid-19 induced lockdown.

Upon noticing that one baby was dead, doctors at Amuria Health Centre IV referred them to Soroti Regional Referral Hospital, who also sent them to Mulago hospital.

“While at Mulago, we were left in suspense. No doctor attended to us until we received a letter discharging without any attempt to separate the baby from its decomposing twin sister,” Mr Paulo Oluo, the grandfather of the babies, said.

He added: “ The doctors thought both babies could die instantly but to their dismay one has remained alive for the last six days while still attached.”

He added that upon receiving the discharge letter from Mulago they lost hope and got distressed after they failed to secure an ambulance to transport the twins.

“I lost hope. I knew they were discharging us for our baby to die at home. Our request to use the Mulago hospital ambulance was futile as management asked for Shs1.3m which we didn’t have.”

During this entire process, the mother of the babies was unconscious and recuperating at the health facility.

They sought assistance from a staff member at Mulgo hospital, Dr Carolyn Akello Agwau, who gave them money to hire a vehicle . On their way home, Mr Aluo revealed that they decided to go back to Soroti hospital to seek assistance from the surgeons.

At Soroti hospital, he said, they consented to being responsible for any outcome of the risky operation
Dr Joseph Epodoi, the consultant surgeon at Soroti hospital, who also spearheaded the operation said there was a layer of living cells separating the babies.

He added that the twins were also surviving on different body organs, which made the surgery a success.
Dr John Ekunait explained that development conjoined twins usually happens when the hormones responsible for separating the twins are faulty.

He said the abnormality occurs in case the twins fail to separate fully in a period of 13 days of conception.

About conjoined twins

Conjoined twins are two babies who are born physically connected to each other.

Conjoined twins develop when an early embryo only partially separates to form two individuals. Although two fetuses will develop from this embryo, they will remain physically connected — most often at the chest, abdomen or pelvis.

Conjoined twins may also share one or more internal organs. Though many conjoined twins are not alive when born (stillborn) or die shortly after birth, advances in surgery and technology have improved survival rates.

Some surviving conjoined twins can be surgically separated. The success of surgery depends on where the twins are joined and how many and which organs are shared, as well as the experience and skill of the surgical team.