Twin to twin transfusion syndrome (TTTS) is a serious disorder that occurs in identical twins and higher order multiples who share a placenta. This occurs when there is a connection in the two babies' blood vessels of their shared placenta. This results in one baby (this twin is referred to as the recipient) receiving more blood flow, while the other baby (this twin is referred to as the donor) receives too little. Twin to twin transfusion syndrome is also referred to as chronic intertwin transfusion syndrome.
TTTS occurs about 15 percent of the time among identical twins. Fraternal twins are not at risk for this syndrome because they do not share a placenta.
TTTS is a random event that cannot be prevented by doing or not doing any specific thing. It is not a genetic disorder nor is it a hereditary condition.
Your healthcare provider may suspect this disorder if any of the following is seen during an ultrasound:
A mother whose twins have TTTS may experience:
Up until recently twin to twin transfusion syndrome has claimed the life of both babies, but technology has brought about two new treatment options for this condition. The use of amniocentesis to drain off excess fluid appears to improve the blood flow in the placenta and reduce the risk of preterm labor. Amniocentesis can save approximately 60% of affected babies. Laser surgery can also be used to seal off the connection between the blood vessels and appears to save 60% of affected babies. Delivery is also an option if your healthcare provider determines the twins' lungs have reached maturity.
Amniocentesis may need to be done repeatedly throughout the pregnancy to maintain proper blood flow in the placenta, while laser surgery usually only requires one treatment.
Complications can include:
The Twin to Twin Transfusion Syndrome Foundation recommends that weekly ultrasounds be performed after 16 weeks through the end of the pregnancy to monitor TTTS. They recommend that this be done even if the warning signs of TTTS have decreased.
The TTTS Foundation can be contacted at http://www.tttsfoundation.org/ or at 1-800-815-9211.
Reprinted with permission from American Pregnancy Association