One Siamese twin dies after emergency op lasts 12 hours

Battle lost: Hope Williams, right, died after 12 hours of surgery to separate her from her sister. They had a combined weight of 10lb 8oz
Anna Davis @_annadavis13 April 2012

Surviving conjoined twin Faith Williams was in a stable condition today after the death of her sister Hope.

Surgeon Professor Agostino Pierro said she still required breathing support but was "gradually improving", after he led a 12-hour operation to separate the twins.

Professor Pierro added: "I think the next few days will be particularly important to tell us how Faith is doing. I would say she is 50:50. If everything goes well and all the complications are well treated then she could have a normal life."

The doctor, who is Nuffield Professor of Paedriatric Surgery at Great Ormond Street Hospital, said the lungs of smaller twin Hope had not been large enough for her to survive.

She and Faith were moved to separate theatres after surgery but her lungs gave out shortly afterwards.

The twins' parents, Laura Williams, 18, and her husband Aled, 28, were with Hope as she died.

A team of more than 20 experts led by Professor Pierro carried out the emergency surgery on the twins after a blockage was discovered in their joined intestines.

The doctors would normally have waited until the baby girls, who had a combined weight of 10lb 8oz, were older and stronger before operating, but knew there was a risk that emergency surgery would be needed because the sisters shared a circulatory system.

Faith and Hope, who were joined from the breastbone to the top of the navel but had separate hearts, were born last Wednesday by Caesarean section at University College Hospital, London. They were taken into theatre at 9am yesterday.

Professor Pierro said: "We needed to operate because the children's health was going downhill.

"This was an emergency operation because there was a blockage in the joined intestines which could only be resolved through separation.

"The technical separation worked well - although it was extremely challenging - and went according to plan.Over 20 staff were involved, with the children moved into different theatres after separation was over.

"Very sadly, after separation, baby Hope's lungs proved too small to support her breathing and she died last night in the presence of her parents.

"They are clearly devastated by the loss of their daughter and we offer them our deepest condolences on their loss. Baby Faith is stable after separation. She requires support for her breathing but she is gradually improving.

"However, it is early days and complications can occur." Baby Faith was expected to remain at Great Ormond Street for several weeks.

A spokesman for the hospital told the Standard: "She is a premature baby who has had a major operation."

The girls' parents say they are praying for Faith's survival. The couple from Shrewsbury, who have another daughter, 18-month-old Carly, gave the go-ahead for surgery after the twins' condition deteriorated on Monday night.

A team of general surgeons, cardiologists, neurologists, neurosurgeons, intensive care surgeons, radiologists, and nurses had been on standby for the operation since the birth.

The sisters' hearts had significant congenital abnormalities. They shared large blood vessels and were joined at the liver and intestine. Mrs Williams was "distraught" the night Hope died, her brother said today.

Warren Rackham, 20, said she was overcome with anxiety about what would happen to Faith and Hope just hours before the operation. Speaking as he visited his mother Wendy's home in Shrewsbury, Mr Rackham said: "She was distraught because she didn't know what was going to happen."

Mrs Williams made medical history by becoming the world's youngest mother of conjoined twins.

She and her husband Aled, a dustman, had been advised by doctors to have an abortion but they refused.

Speaking shortly after the birth Mrs Williams said: "They wheeled me in to see them. They had tucked Hope's arm underneath and it was Faith's arm that I could see. I took her hand and she was grasping my hand. They were both blowing bubbles. They were so beautiful. After everything everyone said, I'm so glad to have proved them wrong."

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