How to return your baby to his or her crib when he or she has passed away in the first week of life?
It’s the topic of an intriguing new study published in The Lancet.
The study, published in the journal Neurology, looks at the recovery and health of twins who have died from complications after having twins separated at birth.
It found that twins who were separated at the time of birth were at a lower risk of experiencing complications after death than those who were born together.
“In terms of survival, it’s important to realise that there is no such thing as ‘one size fits all’ and that there are many different factors involved,” said lead author, Dr Rajesh K. Srivastava from the Centre for Child Health at the National Institute of Medical Sciences in Bengaluru.
The authors say there are two types of complications that can result in twins separated by birth: premature rupture of membranes and congenital anomalies such as a birth defect or a brain abnormality.
The results showed that twins separated during pregnancy were more likely to experience premature rupture and congenitals such as cleft lip and palate.
“The more complications a twin has, the greater the risk of complications after the death of the twin,” Dr Srivathava said.
“There are a number of factors which play a role in premature rupture, including a preterm birth, a severe birth defect, or congenital anomaly.
We also need to understand that this is an event which happens to a whole family and that it has a profound impact on the entire family.”
These factors should be addressed as part of the medical care of twins separated before they are born.
“The study also found that twin separation in the neonatal period is associated with a significant increase in the risk for premature rupture.”
It has been shown that twins have an increased risk of premature rupture in the brain due to an increase in brain volume in the newborn,” said Dr Sivapalan from the University of Adelaide.”
If we are talking about a birth where there are structural problems, the brain should be smaller.
“We have to consider the risks of a premature rupture as the mother is very young and is exposed to very high levels of stress in the womb.”
However, the baby also is exposed and this can increase the risk.
“For instance, in the case of a baby who has a birth injury or who has some sort of neurological disorder such as cerebral palsy, the chances are very high that the child will be born premature and have an increase of brain volume,” Dr K.S. Sivacar said.
In the current study, the researchers analysed twins who had died before the age of two.
They found that premature rupture was also associated with an increased number of congenital abnormalities.
“They have an elevated risk of having congenital malformations such as craniofacial deformity, head deformity or cleft palate,” Dr. Sravastava said.
“They also had a higher risk of preterm births, which in turn, leads to a higher mortality rate and is associated to increased morbidity and mortality.”
Therefore, it is important that the neonates are managed appropriately.
We need to have a better understanding of the factors which are associated with premature rupture so that a proper medical intervention can be given,” Dr E. S. Srinivasan said.