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Conditions We Treat

Twin-to-Twin Transfusion Syndrome (TTTS)

Identical twins who share one placenta may be at risk for Twin-to-Twin Transfusion Syndrome (TTTS). The single placenta contains blood vessels going from one baby to the other. In TTTS, blood from the smaller donor twin is transferred to the larger recipient twin, causing an uneven exchange of blood.

What Is Twin-to-Twin Transfusion Syndrome?

Identical twins who share one placenta may be at risk for Twin-to-Twin Transfusion Syndrome (TTTS). In TTTS, blood from the smaller twin is transferred to the larger twin, causing an unequal exchange of blood. The larger twin is at risk for heart failure because of receiving too much blood from the donor twin. Too much blood forces the heart to work harder. The donor twin is smaller because he or she sends blood to the co-twin. The exact cause of TTTS is not known.

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How Is Twin-to-Twin Transfusion Syndrome Diagnosed During Pregnancy?

TTTS may be found during routine prenatal ultrasound. If your doctor suspects a problem, additional tests may be ordered. These tests may include:

  • Fetal echocardiogram: A specialized ultrasound to look at your baby’s heart.
  • Ultrasound: A type of imaging that uses sound waves to see inside the body
  • Fetal MRI (magnetic resonance imaging): This type of imaging gives more detailed pictures of your babies’ brains that may not have been seen on ultrasound.

How Is TTTS Treated During Pregnancy?

If a test finds you are carrying a baby with TTTS, you will continue to receive care from your obstetrician. If you are referred to the Fetal Center at Nationwide Children’s, you will receive coordinated care from obstetricians who specialize in taking care of pregnancies affected by twin-to-twin transfusion. Diagnostic tests and procedures may include:

  • Ultrasound: A type of imaging that uses sound waves to see inside the body to evaluate fluid levels, the babies’ hearts and blood flow.
  • Amnioreduction: Removes excess amniotic fluid with a thin needle
  • Septostomy: Uses a needle to make very small holes in the membrane separating the twins, so the amniotic fluid will equalize.
  • Selective Laser Photocoagulation (SFLP): Nationwide Children’s is one of only a few fetal centers in the country to perform this procedure.

What Are My Babies’ Outcomes (Prognoses)?

Your doctor will discuss whether a vaginal or cesarean section delivery is best for you and your babies. This may not be decided until just before the delivery.

Connect With Our Team

Our team is here to help as soon as you learn your baby may have a fetal concern or diagnosis. And a physician referral is not required. Our expert team evaluates and treats nearly every fetal complication, from the most common to the most complex conditions. With access to advanced diagnostic imaging, ultrasounds and fetal MRIs, you'll find the answers, and the treatment, here.

 

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