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Twins Joined at Head Are Separated During Operation

August 23, 1995

AUSTIN, Texas (AP) _ Doctors who separated 13-week-old twins born joined at their heads focused today on saving one of the infants, while the fate of her terminally ill sister remained ``in God’s hands.″

In a 13 1/2-hour operation Tuesday, Michelle Tejeda was separated from her sister, Nichelle. The girls were born 13 weeks premature and shared a small portion of their brains.

The separation procedure, believed to be the first ever in Texas, went well, according to officials at St. David’s Hospital. Both infants were listed in stable, critical condition this morning in the hospital’s intensive care unit for newborns.

Nichelle is given no chance of survival because she has a herpes infection she inherited in the womb. The disease has destroyed part or all of her intestines, stomach, bladder, kidneys, liver and brain.

The hospital said it would try keeping the little girl comfortable, although there would be little attempt to prolong her life.

When asked how long Nichelle was expected to live, Margaret Whitfield Morton, marketing director for the hospital, said: ``It’s in God’s hands.″

Even for Michelle, who has shown no signs of herpes infection but has battled other problems, ``it is a complicated situation,″ said Richard M. Turbin, St. David’s senior vice president of medical affairs. He said the long-term outlook was ``guarded.″

Alicia Tejada, who gave birth to the girls May 15, cried when told the girls had been separated, said Larry Schaubhut Jr., the mother’s court-appointed lawyer.

``She was very sad that Nichelle is dying, but at the same time, she was excited that Michelle has come so far,″ Schaubhut said.

Michelle and Nichelle, who now weigh just 6 pounds, 4 ounces each, became only the sixth set of twins to undergo separation surgery worldwide since 1991. Neurosurgeons Gordon White and Lee Berlad began the daylong procedure Tuesday morning.

The infants have been temporary wards of the state since June, when a judge ruled that Ms. Tejeda was unfit to make decisions about their care.

In February, before the twins were born, a court removed Ms. Tejeda’s other six children from her care for abuse and neglect, said Texas Protective and Regulatory Services spokesman Stewart Davis. A hearing will be held later this year on whether Ms. Tejeda is now fit to care for her children.

Conjoined, or Siamese, twins occur when a single fertilized egg fails to divide completely to form identical twins. They occur once in every 50,000 births. Craniopagus twins, those joined at the head, occur only once in 2.5 million births, the hospital said.

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