Twin to Twin Transfusion Syndrome (TTTS) is a serious condition that affects identical twins or higher-order multiples who share a placenta. This occurs when the blood vessels in the shared placenta become connected, leading to unequal blood flow. One twin, referred to as the “recipient,” receives an excessive amount of blood, while the other, known as the “donor,” does not get enough. This syndrome is sometimes described as a chronic form of transfusion between twins.
How Common is TTTS?
TTTS occurs in about 15% of identical twin pregnancies. Fraternal twins are not at risk for this condition since they do not share a placenta.
Preventing TTTS
Currently, there is no specific way to prevent TTTS, as it is an unpredictable occurrence and not hereditary.
Diagnosis of TTTS
Your healthcare provider may suspect TTTS during an ultrasound if they observe any of the following signs:
- Significant size disparity between the twins of the same sex
- Variation in the size of the amniotic sacs
- Differences in the umbilical cord sizes
- A single shared placenta
- Signs of fluid accumulation under the skin of either twin
- Congestive heart failure in the recipient twin
- Polydramnios (excess amniotic fluid) in the recipient twin
- Oligohydramnios (very little amniotic fluid) in the donor twin
Maternal Symptoms of TTTS
Mothers carrying twins with TTTS may experience:
- Rapid growth of the abdomen
- An unusually large uterus for gestational age
- Abdominal pain, tightness, or contractions
- Sudden weight gain
- Swelling in the hands and legs early in pregnancy
Treatment Options for TTTS
Until recently, TTTS often resulted in the loss of both twins. However, advancements in medical technology have introduced new treatment options:
- Amniocentesis: This procedure drains excess amniotic fluid, improving blood flow and reducing the risk of premature labor. It has been shown to save approximately 60% of affected babies.
- Laser Surgery: This technique seals the connections between blood vessels and also has about a 60% success rate in saving the affected twins.
- Delivery: If the healthcare provider determines that the twins’ lungs have matured, early delivery may be considered.
Advantages of Laser Surgery Over Amniocentesis
Unlike amniocentesis, which may need to be performed multiple times during the pregnancy, laser surgery typically requires only one treatment.
Potential Complications of TTTS
Possible complications from TTTS include:
- Preterm labor, either due to membrane rupture or induction
- Respiratory, digestive, cardiac, or neurological defects in the recipient twin from fluid overload
- Anemia in the donor twin
- Fetal demise
Ongoing Monitoring
If diagnosed with TTTS, regular weekly ultrasounds are recommended starting at 16 weeks until delivery, even if warning signs seem to lessen. For further information, you can visit resources such as the NICHD for comprehensive insights into pregnancy and home insemination.
In conclusion, understanding Twin to Twin Transfusion Syndrome and its implications is crucial for expectant parents. Being informed can help in making the best decisions for both the mother and the twins. For those exploring options for conception, resources like Vegas Pregnancy and Make a Mom offer valuable assistance. Learn more about how at-home insemination works at Make a Mom’s demonstration page.
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