Sunday, December 17, 2017

Specialist: Many risks in multiple pregnancy

The 28-year-old woman who is having the region's first sextuplets was advised of the high risks involved in having six babies and was offered foetal reduction but she refused based on religious views.

Since last month, the woman, who will be a first-time mother, has been hospitalised at Mt Hope Women's Hospital under 24-hour monitoring by hospital staff.

A special team of doctors, nurses and midwives has been put in place for the woman's pregnancy.

The six babies are scheduled to be delivered via elective Caesarean section on March 14. She is currently stable and resting comfortably at the hospital.

Sources told the Express that there are very high risks associated in having a multiple-birth pregnancy and the woman was advised of this by doctors at Mt Hope, but opted to take the chance and proceed with having all six babies.

Yesterday, the Express spoke to Dr Catherine Minto-Bain, medical director of Trinidad and Tobago IVF and Fertility Centre, on the issue and she disclosed that since news of the sextuplet pregnancy became public, many women who visited the clinic are scared that they could end up in a similar position.

"We got a lot of patients coming to us, they are scared, they don't want to be getting multiple pregnancy, they know the risks involved and they are asking why we would have possibly done it. It is categorically not our clinic, our guidelines, the way we work...twins are something we have very low rate, we haven't had triplets in five years," she said.

Minto-Bain said there are cases globally where multiple births are featured in the media, but there are also many complications that people do not read or hear about.

"You see the odd case around the world of five, six, seven babies being born and having a relatively normal life, but what you don't see are the massive miscarriages, the massive pre-term birth, the parents on the newborn baby unit with these tiny babies that are going to have millions of dollars of treatment, they are going to struggle with lung disease, infections, they are going to be intellectually impaired.

"A lot of them don't make it after a month on the neonatal unit so that the huge burden that goes along with multiple pregnancy is often what you don't see in the newspapers, you see the very rare ones that successfully get through and have a relatively normal life. It is not impossible, but the risks involved in getting to a normal baby is so high, it is unusual," she added.

Minto-Bain, who is from the United Kingdom, said there is an absence of regulations and legislation in Trinidad and Tobago with respect to fertility treatment.

"If you've got a country where you've got no regulation, unmonitored use and easy access to fertility drugs, you are going to get a situation where there is more and more of these pregnancies and they are pregnancies that you do not want to create because they have much higher risks, miscarriages, cerebral palsy...the problems for the baby and the mother, death rate is increased in multiple births."

She noted that in the United States, there are no strong regulations and there was a case of a mother having eight babies.

In the UK, Minto-Bain said, there are proper regulations in place which are supported by the people.

In Trinidad and Tobago, regulations and legislation were absent.

The IVF and fertility centre, she said, have an ethics committee in place and is accredited by regulatory authorities outside this country.

Questioned on the mother of the sextuplets and whether she should have accepted foetal reduction, Minto-Bain said: "I think that's a very difficult issue in Trinidad and Tobago and the issue of termination of pregnancy is a difficult one for a woman who is pregnant, having desperately wanted to get a pregnancy the idea of reducing those foetuses, choosing the ones that will live, the ones that will die is heartbreakingly difficult.

"I pray for her, I pray that they have a healthy delivery, that they get a healthy delivery, they get further through her pregnancy, the further she gets the better the chance those babies have. We send our best wishes and prayers for a healthy outcome."