One of the conjoined Guatemalan twins separated in a risky operation a week ago is still lagging behind her sister as they recover from the lengthy surgery, doctors say.
Both Maria de Jesus and Maria Teresa Quiej Alvarez remain in critical condition with stable vital signs at UCLA's Mattel's Children's Hospital, but were moving their limbs and responding to stimulus.
Maria Teresa is lagging behind her more alert sister, probably because of the five extra hours of surgery she underwent to remove a buildup of blood on her brain, UCLA said.
"As with any complex brain surgery on small babies, it takes a while to recover," said Dr. Irwin Weiss, a pediatric intensive care specialist. "They are both showing very positive signs of recovery and we remain cautiously optimistic about their long-term prospects."
Doctors have kept the two under sedation, but reduced their dosages. The sisters were tolerating intravenous nutrition, doctors said.
Last week, doctors had begun using an IV to feed the Guatemalan twins who were born joined at the head and separated in a lengthy surgery.
Through the IV, the twins were receiving proteins, minerals and vitamins.
Both twins were moving their hands and feet "in a normal fashion," and opening their eyes to look around, said Dr. Andy Madikians, attending physician in the pediatric intensive care unit at UCLA's Mattel Children's Hospital.
"That's what we'd like to see," Madikians said.
The one-year-old twins were born joined at the head and separated in a 22-hour surgery this week.
A UCLA Medical Center spokeswoman says they're progressing exactly as doctors had hoped.
Maria de Jesus was the first to show eye movement. Maria Teresa began making movements later but was not as animated as her sister.
"Maria de Jesus is responding a little bit more. You squeeze her hand and she pulls away. ... It might be the one who is more responsive only had one surgery," Madikians said.
The girls were born in rural Guatemala to Alba Leticia Alvarez, 23, and Wenceslao Quiej Lopez, 21. The father works as a banana packer, earning the equivalent of just $64 every three weeks, a grandfather of the twins said Thursday in Belen, Guatemala, where residents eagerly awaited reports on the twins' recovery.
"Thank God there were specialized doctors," said Wenceslao Quiej Hernandez.
The girls were attached at the top of the skull and faced opposite directions. They shared bone and blood vessels, but had separate brains. Such cases occur in fewer than one in 2.5 million live births.
The risky surgery involved separating veins that connected the girls' heads, and plastic surgery to extend the scalp of each child to cover the portion of exposed brain.
The two still face follow-up surgeries to reconstruct their skulls.
The twins' $1.5 million surgery was arranged by Healing the Children, a nonprofit group in Spokane, Wash. The UCLA doctors donated their services, but the hospitalization costs remain to be covered.