It took a 55-hour surgical procedure to separate Safa and Marwa, two-year-old Craniopagus twins. The delicate operation took place at the Great Ormond Street Hospital in London, and required the involvement of a hundred medical experts.
“Grace to God, I can now squeeze each of my daughters for an hour, one after the other,” said Zainab Bibi, the mother of the two girls. The mother and 34-year-old widow also remembered to thank the London hospital and the entire medical team who managed to meet a real challenge. It is indeed at the Great Ormond Street Hospital that Safa and Marwa, who were born merged by the head, were successfully detached following a very long and risky procedure.
1 case out of 2.5 million births
In January 2017, Safa and Marwa are born in northern Pakistan. They are Siamese, as 1 birth out of 100,000 in the world. Their mother, who lost her husband two months before birth, is all the more surprised that, according to the Gulf News, she did not even know she was living a multiple pregnancy.
Even rarer, they are Craniopagus twins, which means they are attached by the skull. That is a condition that affects only 2 to 6% of Siamese twins. The chances of survival are very low. According to statistics, 40% are stillborn, and 33% die shortly after birth due to organ failure and/or abnormalities. But 25% survive and even have the option to be surgically separated depending on the attachment of the skull. Safa and Marwa are part of this 25%.
A 4-step procedure over 4 months
After consulting several specialists in Pakistan, the two sisters were finally sent to the Great Ormond Street Hospital in London in the fall of 2018, where neurosurgeon Noor ul Owase Jeelani and plastic surgeon David Dunaway worked twice on cases. In a statement, the school said it had “set up a separation procedure in 4 steps over 4 months that involved many specialties: from craniofacial to physiotherapy via neurology, radiology, experts in psychology and many nurses.”
In all, a hundred professionals were involved in the fate of these binoculars Craniopagus. To prepare for multiple operations, the team used virtual reality to create a 3D replica of both skulls.
“I thought Safa was dead”
The first intervention was to separate the brains and arteries and the second, a month later, to separate the veins. But a complication arises after that one and Professor Jeelani fears the worst when one of the sisters has a heart attack twelve hours later. “I thought Safa was dead,” he told the BBC. Fortunately, the girl is recovering and the 3rd intervention can take place in January 2019.
Doctors insert tissue that will stretch the skin to cover the skull of each during the final separation, which takes place in February. The latter operation, which was paid for by a Pakistani businessman, also allowed the reconstruction of the top of their skull using bone fragments from each of the two sisters.
After several months of recuperation and physiotherapy, Safa and Marwa were able to leave the hospital a few weeks ago. They should return to their native Pakistan early next year.
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