Sound wave therapy..
A potentially life saving and non invasive treatment using high intensity sound waves could bring new hope to families suffering the rare and potentially fatal pregnancy complication called twin to twin transfusion syndrome (TTTS). A new study by scientists at Imperial College London and Imperial College Healthcare NHSTrust has revealed that using high intensity focused ultrasound (HIFU) to block anomalous blood vessels in the placenta does not have any adverse effects on the mother or their unborn child.
The findings published in the American Journal of Obstetrics and Gynecology (AHOG) found that about 1 in every 10-15 identical twins develop TTTS with about 300 to 400 pregnancies affected each year in the UK. Experts say that the condition occurs when the blood supply to the babies is not equal because of the abnormal blood connections in the shared placenta. If left untreated both twins can suffer from heart failure, organ damage and death with one twin receiving too much blood and the other too little.
As of now the only treatment option is inserting a fetoscope into the womb and sealing the abnormal blood vessels with a laser beam. The procedure is successful in many cases but it's also invasive and has risks such as miscarriage or pregnancy complications.
The first human feasibility study involved 10 cases of early onset TTTS between 12 to 17 weeks of gestation who were recruited from the UK and Europe. Using Doppler ultrasound the researchers were able to locate the very small blood vessels. They would then beam high-energy sound waves at a machine positioned on the outside of the body to heat and obstruct these vessels, which would then help to restore balance of blood flow between the twins.
It was found that the procedure was effective in blocking blood vessels in the placenta in 90 percent of the cases. Most importantly no women or babies had any negative side effects during the participation. However the study was not designed to test effectiveness researchers could not determine whether HIFU can stabilize or reverse TTTS. Later in the course of the study 50 percent of the women had to be treated again using laser therapy and some babies did not survive because of the severity of the condition.
The results are "very promising," said Professor Christoph Lees of Fetal Medicine at Imperial College Healthcare NHS Trust and Professor of Obstetrics at Imperial College London. The team now hopes to conduct a larger trial with 50 to 100 women to see if HIFU can be a comparable but less harmful and invasive option for treatment.
Brioney Garrett from Cornwall was diagnosed with advanced TTTS in her 12-week scan in 2022. Having none of the other available treatment options she entered into the HIFU trial and eventually became the mother of two healthy twin daughters named Margo and Nancy.
The study provides valuable proof of concept for the potential of using high-intensity focused ultrasound as a safe non-invasive treatment for TTS. The results are an important developmental step towards better care and outcomes for families experiencing this rare pregnancy complication, although additional studies are needed.
Disclaimer: This early-stage clinical trial primarily assessed safety. Larger studies are needed to confirm the treatment's effectiveness before it can be adopted in routine clinical practice.
