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Baby born with a parasitic second head dies despite 18-doctor surgical marathon
Telegragh ^ | 2/8/04 | Michael Day, Health Correspondent

Posted on 02/07/2004 6:57:36 PM PST by mylife

Baby born with a parasitic second head dies despite 18-doctor surgical marathon

By Michael Day, Health Correspondent (Filed: 08/02/2004)

An attempt to remove an undeveloped second head from a baby girl born with one of the world's rarest birth defects ended in tragedy yesterday when she died hours after undergoing surgery.

In a pioneering 12-hour procedure, an international team of doctors had separated Rebeca Martinez, a seven-week-old infant from the Dominican Republic in the Caribbean, from the "parasitic head" that was growing faster than her own and that, left attached, would have killed her.

Rebeca's condition, craniopagus parasiticus, or parasite twin disease, is so rare that there have been only eight documented cases in the world. There are no known cases in which surgery has been attempted to correct it. The operation to save Rebeca, at a hospital in Santo Domingo, the capital of the Dominican Republic, involved a team of 18 doctors, working in shifts.

The surgery - described by one doctor as "formidably complex" - was at first thought to have been a success. The second head, which grew from the top of Rebeca's skull and had its own partly developed brain, ears, eyes and lips, was cut off, while intertwined blood vessels were separated and clipped.

Eventually, her skull was closed using a bone-and-skin graft from the second head. Afterwards, Dr Benjamin Rivera, one of a team of American doctors who flew to Santo Domingo to carry out the operation at the city's specialist orthopaedic centre, declared that the procedure "went very well".

While he said that the next 24 to 48 hours would be critical because the baby had suffered considerable blood loss, a hospital spokesman said that once the initial recovery period was over Rebeca was expected make a full recovery in a matter of weeks and could expect to lead a normal life.

Her father, Franklin Martinez, 28, was overjoyed at the news. "We are super-happy," he said. "This is what we hoped for and it happened. The only new thing now is that she will be coming home without the extra part she used to have."

Twelve hours later, however, he and his wife, Maria Gisela Hiciano - who had earlier followed her daughter to the door of the operating theatre, caressing her head and saying, "Be strong, Rebeca. May God be with you" - were left heartbroken.

"She was too little to resist the surgery," Maria, 26, said between tears. The couple have two other children, aged four and one.

Before the operation, doctors had said that it was risky but necessary. "The head on top is growing faster than the lower one," said Dr Jorge Lazareff, the head of paediatric neurosurgery at the University of California's Mattel Children's Hospital, who led the team. "If we don't operate, the child would barely be able to lift her head at three months old."

He admitted that there was a significant risk of heavy bleeding during the operation because one of Rebeca's main arteries supplied blood to the second head.

The costs of the surgery, estimated at $100,000 (£61,000), were met by the charity Cure International. Rebeca's parents together earn just $200 a month.

Few cases of craniopagus parasiticus have ever been documented anywhere in the world and none has ever been recorded in Britain. Parasitic heads draw away vital nutrients and can become so heavy that the victims are unable to move.

Doctors believe that it occurs when one of conjoined or "Siamese" twins - a condition caused by the failure of twins to separate at the earliest stages of embryonic development - fails to develop fully in the womb.

Dr Alan Cameron, a consultant obstetrician and a specialist in foetal development at the Queen Mother's Hospital in Glasgow, said that it was wrong to consider the parasitic head as another living person.

"There would have been absolutely no chance whatsoever of the second head having consciousness in any way because the brain would not have been developed enough," he said.

The eyes and mouth of the second head were poorly formed and non-functioning and it would have relied on the fully formed baby for all of its oxygen and nutrients. Dr Cameron said that the causes of such a freakish biological mishap were less clear. "The condition is so vanishingly rare that we really don't understand how or why it happens."

He said that the failure of vital developmental genes, called HOX genes, to become activated might lie behind the stunted development. "The truth is, though, that we really don't know at the moment."

Dr Cameron said: "It's terribly sad that the baby didn't make it but the doctors had to try. Without surgery the baby certainly would have died; the pressure on the little girl's brain and neck would have been too much.

"We shouldn't be that surprised she didn't make it, though. There would have been vascular complications. The blood loss would have been so great that the baby would have gone into shock."


TOPICS: Miscellaneous; News/Current Events
KEYWORDS: rebecamartinez; surgery

1 posted on 02/07/2004 6:57:39 PM PST by mylife
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Comment #2 Removed by Moderator

To: mylife
Despite the surgery, or BECAUSE of the surgery?
3 posted on 02/07/2004 7:06:39 PM PST by Pikachu_Dad
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To: Matthew1986_18
Scroll about one third of the way down of this page. I believe this is the poor little girl.

Heartbreaking.

http://xoomer.virgilio.it/medicine/pathohomotissuemof.html
4 posted on 02/07/2004 7:07:23 PM PST by texasflower (in the event of the rapture.......the Bush White House will be unmanned)
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To: Pikachu_Dad
Rest in peace. Under that second head she looked like a beautiful baby.
5 posted on 02/07/2004 7:17:06 PM PST by Cicero (Marcus Tullius)
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To: Pikachu_Dad
From what I read, the second head was growing faster than her own and she would have died anyway. This was a chance. Her only chance.
Both beautiful babies are playing with angels now.
6 posted on 02/07/2004 7:19:36 PM PST by netmilsmom (Homeschooling 1/5/04-6 yr.old now 2nd Gr./3 yr old now K)
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To: mylife
Very sad for that little angel. Operating on babies is very dangerous stuff. My own daughter was operated on two days after emergency, early c-section birth and it was touch 'n go for two days. What the doctors thought was a blocked kidney turned out to be an extra, undeveloped kidney which they removed.
7 posted on 02/07/2004 7:36:53 PM PST by open mind-closed fist
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To: open mind-closed fist
Glad things worked out well
8 posted on 02/07/2004 7:40:58 PM PST by mylife
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To: Pikachu_Dad
"Despite the surgery, or BECAUSE of the surgery?"

WTH's she supposed to do, carry the thing around w/ her for her entire life...?

9 posted on 02/07/2004 7:41:51 PM PST by wingster
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To: wingster; Pikachu_Dad
"Despite the surgery, or BECAUSE of the surgery?"

She never would have made it out of childhood without the surgery, chances were she would not have made it far out of infancy. This condition is a death sentence. the surgery was a long shot to save her.

10 posted on 02/07/2004 7:49:02 PM PST by Ophiucus
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To: mylife
Thanks, she's fifteen now, has always been a top student and...well lets just say the boyz don't have no interest in helping me clean my guns, lol.
11 posted on 02/07/2004 8:44:55 PM PST by open mind-closed fist
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To: mylife
I saw her picture and hoped that she would make it. How sad for the parents. And how gracious and loving for charitable groups to help on these terrible deformity cases.
12 posted on 02/07/2004 8:52:59 PM PST by Libertina
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To: Pikachu_Dad
What kind of person would say such a thing.
13 posted on 02/07/2004 8:55:54 PM PST by Hildy
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To: mylife
I have beautiful, identical twin girls. I thank God every day that they were born healthy and whole. We've all seen so many cases of co-joined twins in the last few years and this, sadly, was one of the worst cases.
14 posted on 02/07/2004 9:07:01 PM PST by potlatch (Whenever I feel 'blue', I start breathing again.)
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