Having already a “textbook” pregnancy with their first daughter Lily, who is now five-years-old, Mrs. Angela Formosa admitted she was shocked when she found out her twins were joined together. Knowing already how dangerous it is giving birth to conjoined twins, being told by her doctor that the odds for the babies’ survival were low only made the expected parents shocked and very sad.
Nevertheless, after the babies were born, emergency surgery was performed on them. Twelve weeks later, the operation was a success and both Ruby and Rosie are at home with their family, despite the fact that there was a good chance they would not survive.
Mrs. Formosa had gone for an early pregnancy scan and became alarmed by the results. She said, “At an early pregnancy scan they said the twins looked very close together so I went to King’s College for another scan. Between 16 and 20 weeks we found out that they were joined – I didn’t know what to think, I was shocked and I felt sad. The news was alarming enough without knowing how they were joined together. We didn’t know what to expect until they were born – the doctors could not tell where they were connected.” She added that, “They decided to deliver them early at 34 weeks.”
Upon delivery, what they expected did not happen, which was a good thing. “We expected them to be really tiny but they weighed 5lb 3oz (2.5kg) each, so that was quite good actually.”
Daniel Formosa, their taxi driver father, talked about the operation and said, “It felt as if we were just signing a life away.” However, the 36-year-old continued saying, “But if they didn’t operate they wouldn’t have survived.”
Luckily for the twins, the operation was performed at London’s Great Ormond Street Hospital (GOSH), which has experience with operating on conjoined babies. The team specialists were led by pediatric surgeon Professor Agostino Pierro, who explained why emergency surgery was needed. “In this case, the twins were joined by the abdomen at the level of the umbilicus and shared part of the intestine. The operation to separate the twins had to be performed as an emergency because of an intestinal blockage.”
GOSH has been cited as being the most successful center in the world when it comes to the care and separation on conjoined twins. They have cared for 32 cases in all and include 25 separations. Surgeons last year were successful in the separation of Ritag and Rital Gaboura from Sudan, who were joined at the head- the most complex, the rarest and life threatening forms of the condition.Pierro added that, “We are delighted with the outcome of the operation. The babies will need further treatment in the future, but we expect that they will both be able to lead happy and normal lives.”
In order to achieve a survival rate of 80 percent, twins being operated on need to be planned in advance and performed during a time when they are well and stable. In the case of Formosa’s twins, Pierro said that the survival rate of the twins were good because of the way they were joined. “The separation of Ruby and Rosie was a complex procedure but was less difficult to achieve than some of the other conjoined twins separations we have successfully carried out at Great Ormond Street Hospital. The joining was not as extensive as some of the other twins that we’ve separated. Nevertheless, the challenges with this specific separation were the joining of the intestine and the intestinal obstruction as well as the unclear anatomy in spite of several pre-operative scans.”
He added that, “Any separation of conjoined twins requires expertise, which I and the team have developed over many years in this hospital. The separation of conjoined twins can involve most of our pediatric specialties, such as general surgery, urology, anesthesia, intensive care, radiology, orthopedics, neurosurgery, plastic surgery, cardiac surgery, nephrology, respiratory medicine, microbiology and nursing staff.”
Conjoined twins are very rare and it is figured that one out of every 250,000 babies is born like Ruby and Rosie. Parents who were in the position of the Formosa’s are fortunate to at least have an option in saving the lives of conjoined twins.
Following the success of the separation operation, Angela was beyond appreciation for what GOSH accomplished in saving her baby girls lives: “What they have done for my two girls is amazing. When I was pregnant they were saying that the survival chances were quite low. For them to have been operated on and doing so well – it is amazing.”
In a baby update, Formosa claims that, “They are really well, they are putting on weight. They are normal bubbly babies who are starting to smile and cry when they want something.”
Conjoined Twins Rosie and Ruby Separated
The parents of Rosie and Ruby Formosa speak about the successful operation to separate the conjoined twins.
Conjoined Twins Separated
Surgeons have successfully separated conjoined twins just a day after they were born. The UK Twins were joined at the abdomen and shared part of their intestines. In a four-hour operation a team of 20 doctors and nurses at Great Ormond Street Hospital in London were able to separate the twins without complications.
Rosie and Ruby Formosa are now doing well and are smiling “bubbly babies”, according to their mum Angela.