Siamese twins die

The twins shared a heart and liver

Natasha and Courtney Smith, 19-day-old conjoined twins, have died in hospital, doctors revealed.

The baby girls were joined at the chest and heart and had been given only a slim chance of survival by doctors at London's Great Ormond Street Hospital.

Parents Tina May, 23, and Dennis Smith, 33, from St Albans, Hertfordshire, were at their daughters' bedside when they suffered a relapse and died at 1750 BST on Friday.

The babies were born at the Queen Charlotte's and Chelsea Hospital in the capital on 29 April.

These unhappy events are broadly as we expected

Professor Lewis Spitz

They were joined from the belly button to the top of the chest.

The death comes little more than two weeks after the doctors treating them decided not to attempt to separate them.

Professor Lewis Spitz, professor of paediatric surgery at Great Ormond Street Hospital expressed his sympathy for the twins' family.

He said: "We offer our sincere condolences to their parents during this extremely sad and difficult time.

"These unhappy events are broadly as we expected.

"The structure of, and the blood supply to, the twins' heart was so complex and abnormal that separation was not considered possible."

Difficult procedure

He added: "The staff involved in their care at GOSH did everything possible to make their short lives as comfortable as possible."

Professor Lewis Spitz, a world expert in twin separation, concluded that the repair of the complex maze of blood vessels surrounding the heart was "virtually impossible."

Construction of a heart to sustain even one baby would have been equally difficult, he said.

No babies in the same situation have ever survived long-term.

He told the BBC that at one stage early in pregnancy, the medical team had been optimistic that separation could be attempted - later scans had painted a bleaker picture.

Family's heartache

The heart the twins shared was mainly in the body of Natasha and they also shared a liver.

Initially it was hoped that by sacrificing her sister Courtney, Natasha Smith could be saved.

But early reports on the twins suggested they were both weakened by breathing difficulties.

They were cared for in intensive care, where doctors supplied oxygen and attempted to feed them.

It was predicted that the heart they shared would not be able to support them both for a great deal of time, particularly as it also had a substantial hole in one of the chambers.

Professor Spitz said death was not unexpected

Their parents, who have an 11-month-old son called Damien, discovered they were expecting conjoined twins following a routine scan in November.

But as a Catholic, Ms May was against having an abortion on religious grounds.

She said of the birth: "My happiness is tinged with the agony of knowing the ordeal that lies ahead for us all."

Conjoined twins occur in about one in 100,000 pregnancies and only about 19 sets have been dealt with at British hospitals since 1984.

Around 40% of conjoined twins are joined at the chest.

It is rare to have only a single heart, but there are frequently heart problems in conjoined twins.