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Anna and Elizabeth RichardsSeparated thoracomphalopagus conjoined twins
Date of Birth: 20.12.2029
Country:  USA |
Content:
Siamese Twins Successfully Separated
Anna Grace and Hope Elizabeth Richards, conjoined twins who shared heart muscle tissue, liver, and diaphragm, were successfully separated at the age of two. They were born on December 29, 2016, fused at the chest and abdomen. After a year in the neonatal intensive care unit, the girls underwent a seven-hour surgery on January 13, 2018, at Texas Children's Hospital in Houston. Currently, the twin sisters are recovering in separate cribs and are expected to go home in a month. "We have been thinking and praying about this day for almost two years," said their mother, Jill Richards. "It is just indescribable to see Anna and Hope in two different cribs."
Biography of Anna and Elizabeth Richards
Born on December 29, 2016, in North Texas, Anna Grace and Hope Elizabeth Richards were known to be conjoined twins even before their birth. Ultrasound revealed that they would be thoraco-omphalopagus twins, joined at the front of their bodies. However, it was only after their birth that the doctors could determine if separation was possible. The sisters were delivered via cesarean section at 36 weeks, weighing a total of 4.42 kg. They were closely monitored to identify which internal organs they shared. According to statistics, conjoined twins occur in one out of every 200,000 births. Despite the increase in hospitals and surgeons willing to perform separations, approximately 65% of conjoined twins do not survive their first day. These twins are not completely separated during embryonic development. Anna and Hope's case, thoraco-omphalopagus, is the most common type, accounting for about 28% of all conjoined twins. Specialists still cannot determine why girls are more likely to be conjoined (70%) and why their survival rate is better than that of boys.
Furthermore, it has been observed that female twins cope better with the consequences of separation. At least 75% of the time, one of the twins survives, although much depends on which organs and body parts the twins share. In cases where the connection is in the spinal area, the success rate reaches 68%. The first separation surgeries were performed in the 1950s, but this complex procedure remains a challenge even for experienced surgeons. In many cases, separation is not feasible because the twins have too many vital organs and interconnected blood vessels. In some instances, separation inevitably leads to the death of one twin, while the surviving twin's chances of survival and a relatively bright future are significantly improved. Fortunately, Anna and Hope's situation was not critical, so the surgery to separate them was planned in the first days of their lives. In November 2017, surgeons operated on the girls to implant tissue expanders necessary for further manipulations. For a whole year, nurses and neonatology specialists provided round-the-clock care for the conjoined twins before their tiny bodies were prepared for separation.
A serious team of 75 surgeons, specialists, and nurses conducted a perfectly coordinated operation, separating their hearts, diaphragms, and livers, and ensuring separate blood flow to their "newly formed hearts." During the procedure, cardiologists had to separate parts of Anna and Hope's hearts, and plastic surgeons carefully placed the once-shared tissue into two different bodies. One of the most challenging aspects of separation surgery is redirecting the blood vessels to ensure that neither twin loses too much blood during the operation and that all organs have continuous blood supply. In the case of Anna and Hope, there was one major blood vessel connecting their partially fused hearts. "Through simulations and countless planning meetings, we were able to prepare for the situations that may arise during separation," said Dr. Larry Hollier, Chief Surgeon and Head of the Department of Plastic Surgery at Texas Children's Hospital. "We are thrilled with the results, and we will continue to help Anna and Hope until they fully recover." The girls will remain in the neonatal intensive care unit until they are strong enough to go home to their parents and older siblings, Seth and Collin. According to some reports, conjoined twins occur in one out of every 200,000 newborns. Between 40% and 60% of such twins are stillborn, and only about 35% survive more than a day. The overall survival rate for conjoined twins ranges from 5% to 25%. For unknown reasons, conjoined sisters have a higher chance of survival than conjoined brothers. The most famous conjoined twins, Chang and Eng Bunker, were born in Siam (now Thailand) in 1811.
