By JULIET ROWAN
Fijian doctors are pleading for help for two baby girls joined at the heart.
The conjoined twins were born on Monday at the Colonial War Memorial Hospital in Suva.
Doctors initially thought they were linked only by the small intestine, but discovered yesterday afternoon that they share a single heart.
They
have appealed to hospitals in New Zealand and Australia for advice on whether it will be possible to separate the girls, born facing each other and with some of the intestine protruding outside their bodies.
If the answer is yes, the twins, who have yet to be named, will need to be transferred out of Fiji.
Hospitals there lack the facilities to perform such an operation.
Last night Dr Joseph Kado, one of the team caring for them at the Colonial War Memorial Hospital, said their condition was very unstable. They had been operated on to reduce the problem with the protruding intestine, and they were on ventilators.
The girls were born by caesarean section.
They were not premature and their mother, Shirin Lata, 24, knew she was having twins, but not that they were conjoined.
Dr Kado said feedback from overseas experts had suggested that the prognosis for conjoined twins with one heart was not good.
The Royal Children's Hospital in Melbourne appeared to be the most likely to provide assistance, he said.
If the twins were able to be transferred there or to another hospital, Dr Kado said New Zealand could help by providing an air ambulance and experts to care for the twins in transit.
Dr Phil Morreau, a paediatric surgeon at Starship Hospital, said whether the twins could be separated would depend on exactly how they were joined. Babies joined at the heart could be successfully separated, depending on the chambers of the heart and the blood vessels by which they were connected, but the risk of complications was high.
Ethical issues would also be raised if an operation could save only one of the babies.
The Auckland District Health Board, which runs Starship Hospital, has received no formal request from either the Fijian or New Zealand governments to operate on the twins.
But Dr Morreau said such a request would be considered if made. The cost could run into the hundreds of thousands of dollars.
The incidence of conjoined twins worldwide is one in 50,000 to 100,000 live births.
