Newborn twins joined at belly - Parents hoping to have them separated

On November 7, Iesha McMurray and her partner Odane Elson welcomed twin girls Azora and Azaria into the world.

Even though both parents have twins in their family trees, Azora and Azaria are extra special as they are conjoined twins, a rarity in Jamaica. According to Dr Leo Walker, the gynaecologist-obstetrician at the Victoria Jubilee Hospital (VJH) who spotted the twins' condition, over the past 50 years, there have been about two cases of conjoined twins locally, one was terminated and the other died shortly after birth.

"This is the first case that has been diagnosed and delivered as a live born. They are three-plus weeks now post delivery," he said. The girls, who were born conjoined at the abdomen, are currently admitted at the University Hospital of the West Indies (UHWI). Their parents are praying that with surgery, their daughters will be separated and live normal lives.

"I haven't heard anything about surgery as yet but they did tell mi about the risks involved. Even if dem ago do the surgery, it would be six months' time because that is what they told me from day one. The twins have a MRI to do and is six weeks' time. Dem brother and sister want to see them but they can't. I haven't got a chance to breastfeed my daughters because of the condition they are in. I have only held them once. It's stressing," McMurray said.

According to the 27-year-old, her first ultrasound appeared normal, but as the norm with twin pregnancies, she was referred by her clinic to the VJH for prenatal care.

"Mi first ultrasound was done at five months and it never show say the babies join. It just show seh dem share di same placenta," she said. It was on her third visit to the VJH that the revelation was made.

"I knew what conjoined twins meant but at the time reality never lick in yet," she said. The Elson girls are less than a month old but they are already showcasing their different personalities.

"One of them is quiet and the other one is very active," she said. But Azora's health is hanging in the balance, as her heart is failing and she has pressure in her lungs.

"She is breathing fast so she is on three heart medications," McMurray said. Walker said McMurray was referred to the Maternal Fetal Medicine Clinic, even though it was initially thought she had a normal twin pregnancy with one placenta, two sacs with two foetuses. But Walker said that immediately upon starting McMurray's scan, it was evident that the twins were joined at the abdomen. He said they share some of the abdominal skin, components of the gastrointestinal tract which is common in the liver, and an umbilical cord. According to Walker, cases of conjoined twins are extremely rare worldwide.

"There is one in 100 to 150,000 and of those that do occur, two thirds of them will usually be terminated because of the severity of abnormalities and or where they are joined. If they share a heart or a brain, then the pregnancy may require termination. Others may have abnormalities so severe that they end up dying in the uterus. Of the remaining one third that are not terminated, around 70 per cent of those may end up dying after the first couple days of life. Just 30 per cent usually live more than a few days after they were born," he said.

Walker said the twins' prognosis depends on the degree of sharing that they are doing, which the upcoming MRI will determine.

"In the best case scenario, where it is just some of the liver tissue that is shared, then we do have the expertise to provide a separation procedure. If it's more complex, then it is not to say we don't have the expertise to do it, but it's more the support post-separation and probably some of the equipment at the time of separation for monitoring," he said.

The family has set up a GoFundMe to assist with medical bills. So far, US$1,500 (approximately $232,000) has been raised out of the US$ 50,000 (approximately $7.7 million) goal.

Persons wishing to assist Azaria and Azora Elson, may contribute at https://gofund.me/19221951