Study: Ultrasound Safely Treats Twin Pregnancy Condition

Is this a breakthrough born from neglect or a distraction from a proven surgical success?

JUL 10·Updated JUL 11

Study: Ultrasound Safely Treats Twin Pregnancy Condition

Story

Above: A Center of Maternity and Women's Medicine in Krakow, Poland, on Sept. 26, 2018. Image credit: Artur Widak/NurPhoto/Getty Images

The Facts

A world-first clinical trial has found that high-intensity focused ultrasound (HIFU) can safely block blood flow in abnormal placental vessels linked to twin-twin transfusion syndrome (TTTS), a condition affecting 10% to 15% of identical twins sharing a placenta that causes an unequal flow of blood between the babies, putting both at risk.
Medicalxpress
Imperial College London
The trial, led by Imperial College London and Imperial College Healthcare NHS Trust, involved 10 pregnant women from the U.K. and Europe and was published in the American Journal of Obstetrics and Gynecology in May. The HIFU device was designed and built by the Institute of Cancer Research in London.
NHS England
BBC News
The procedure successfully blocked blood flow in 90% of targeted placental vessels, with no adverse side effects recorded in mothers or unborn twins. However, half of the 10 participants required follow-up laser treatment, and 12 of 20 fetuses survived to neonatal discharge.
BBC News
American Journal of Obstetrics & Gynecology
Current standard treatment for TTTS requires inserting a small telescope-like device into the womb and using a laser to seal shared blood vessels on the placenta's surface. While often effective, the procedure carries risks including damage to the amniotic sac and miscarriage.
Imperial College London
Medicalxpress
The HIFU technique uses externally applied, targeted sound waves to heat and seal placental blood vessels as small as 2mm in diameter located approximately 5 to 6 centimeters below the skin, without requiring any incision or entry into the uterine cavity.
American Journal of Obstetrics & Gynecology
BBC News
Professor Lees and his team received a £2.2 million grant from the Medical Research Council in 2017 to conduct the trial. The researchers plan a larger follow-up study involving 50 to 100 women to assess whether HIFU can effectively treat TTTS.
Medicalxpress
NHS England

Sources Split

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The Spin

Narrative A

The reason a non-invasive alternative has taken decades to reach first-in-human trials is that maternal-fetal medicine has been chronically underfunded and pregnant patients are still routinely excluded from drug trials. This study is promising precisely because the bar for innovation in women's health has been set so low for so long.

Nature

BBC News

Narrative B

Decades of investment in fetoscopic laser surgery produced a procedure that already saves at least one twin in 89% of cases. That's what sustained research funding looks like when it works. Redirecting attention toward a ten-patient study that hasn't yet shown it can stabilize or reverse TTTS risks abandoning a proven approach.

Sciencedirect

Narrative C

Every major advance in fetal therapy starts with a small safety study before larger trials determine effectiveness. A non-invasive approach that can successfully close abnormal placental vessels without entering the womb could ultimately complement or even replace surgery for some TTTS patients, reducing procedural risks while expanding treatment options if future trials confirm the early promise. This is a meaningful step forward.

American Journal of Obstetrics & Gynecology

Editor's Note

This story currently has limited coverage. We will continue to monitor all major outlets and update our reporting as additional information becomes available.