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Mother grieves over her Siamese twins

“I AM still confused. I will only settle down if a solution is found to my children’s condition. I want them to be separated but I leave everything in God’s hands,” said 34-year-old Christina Moono, a mother from Southern Province who recently gave birth to Siamese twins.
Early this October, Ms Moono, a peasant of Choma district, made headlines after she gave birth to a rare case of Siamese twins sharing an abdomen (omphalolopagus) and pelvis (ichiopagus).
A Daily Mail crew caught up with Ms Moono at the University Teaching Hospital (UTH) where she had been referred to for specialised medical attention for the conjoined twins.
It was the seventeenth Siamese twin case the UTH was recording in almost 10 years.
As Mr Moono looks at the twins with an overflowing mother’s love, she says, “I am proud to have given birth to the twins.’’
She expresses hope that medical personnel at UTH. Zambia’s largest referral hospital will make a medical breakthrough for her children.
A mother of seven, among them a set of twins, Ms Moono narrates the history of her pregnancy and subsequent birth of the conjoined babies.
“I remember going for antenatal check-ups when I was three months pregnant. The next time I went to the clinic was when I was seven months pregnant after experiencing some pain in the abdomen. I was also feeling a strange sensation in my stomach,” Mrs Moono of Hanyati village narrated.
She said medical personnel advised her to avoid performing strenuous chores, a counsel she adhered to almost religiously.
“I suspected that I could have twins because the pregnancy was heavy,” Ms Moono said.
She narrated that she safely delivered the conjoined twins four days earlier than the due date.
But the sight of her new born babies left Mrs Moono in shock.
“When I saw that my children were attached to one another, I was scared, confused and started crying. I thought of how I would manage to take care of them,” she recounted while holding back tears.
Ms Moono is grateful that the nurses at Choma’s Batoka Clinic consoled her and urged her to trust in God.
“As at now, I am still confused. I will only settle down if a solution is found to my children’s condition. I want them to be separated but I leave everything in God’s hands,” she said.
At this point, the twins were in what health personnel described as “fragile but stable condition” while undergoing procedural tests before determining the next action.
Meanwhile, Lasford Munsaka, the father of the twins, was equally confident the medical personnel would find a solution.
“Seeing a joined baby was strange for me, but I have accepted that it has happened and we have left everything in God’s hands,” Mr Munsaka, who was found within the hospital, said.
But tragedy struck barely a day after interviewing the couple. The conjoined twins died, raising more speculation among the public who were still trying to comprehend how the conjoined twins had been surviving and whether or not they would undergo a successful operation at UTH.
So, what would the conjoined twin’s chances of survival be if they were operated on? Was the largest referral hospital competent enough to handle such a rare case of Siamese twins?
UTH neonatal and paediatric surgeon Lupando Munkonge answers some questions raised by some sections of the public following the death of the twins, who the mother could have named Chipego and Choolwe.
Professor Munkonge explained that the Siamese twins, whose sex had not yet been determined, had severe and multiple, congenital organ defects.
“One of them had a heart on the right as opposed to the left where we all have hearts. When a person has that abnormality, so many organs also follow suit, and they go in a different abnormal position. They also had intestinal webs and shared an excreting point,” he said.
Prof Munkonge said, “One of the hearts had abnormal chambers with holes connecting at abnormal positions.”
He cited another complication detected on the twins as multiple organ congenital abnormalities (having many organ abnormalities arising from birth).
He also said it is the first set of twins conjoined in the pelvis and abdomen the hospital had recorded.
Professor Munkonge explained that a team of 12 medical specialists examined the twins and had two sessions to discuss their management.
“We’re happy that at the moment, we have got adequate equipment to use in investigating the patients [Siamese twins] and that is how we managed to detect those congenital abnormalities.
“We [UTH] have huge experience and enough equipment, we have experience of over 30 years in dealing with Siamese cases. So we were capable of handling this set, but unfortunately nature took its course [death] as we were examining the patients within 72 hours,” Prof Munkonge said.
He is the author of General Practioner’s Guidelines in the Management of Siamese Twins.
With the severe congenital abnormalities, Prof Munkonge said the twins, who died within 72 hours in which the team of health experts was observing them, could have had “very little” chances of survival if they had been operated on.
“We don’t just operate for the sake of it, but we look at the quality of life after an operation…had we operated on them, they wouldn’t have had sex organs, non-functional lower limbs, and one of their hearts would have given us a lot of problems because of severe congenital abnormalities,” he explained.
Professor Munkonge urges expectant mothers never to relent on seeking maternity check-ups to prepare for eventualities associated with pregnancy.
“Some fertile ladies take African medicines which they use in form of prevention of pregnancy so that they do not get more children, but this [traditional medicine] can have an effect on the biological make-up of the baby they will deliver,” he said.
According to medical experts, conjoined twins occur in about one in every 400,000 live births.
They develop from a single fertilised egg are, therefore, always identical and of the same sex.
It is unknown why the embryo does not complete the process of separating into identical twins.
One thing comes out clearly, though. Expecting mothers should consistently go for antenatal check-ups so that complications are detected early.

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