Twin to Twin Transfusion Syndrome (TTTS) is a prenatal condition in which twipagi posting ulang unequal amounts of the placenta’s blood supply resultingi in the two fetustape growinew york at berbeda rates. 70% of identical twins share a placenta, and 15-20% of these pregnancies are affected by TTTS. TTTS is not related to anythingi the mother did or did not do duringi pregnancy.

Anda sedang menonton: Twin to twin transfusion syndrome adalah

Identical twimenjadi bagikan one placenta. Paling commonly, they are in berbeda sacs of fluid, the amniotic sacs. This type of twin pregnancy is calpengarahan monochorionic (one placenta) and diamniotic (two sacs). In monochorionic, diamniotic twipejarakan (mo-di twins), tdi sini are shared blood vessels, which run from one twin to the other on the surface of the placenta. Paling often the net flow of blood between the twipagi is fairly even, but when tdi sini is an imbalance of blood flow across these blood vessels, sebagai that one twin is getting more blood supply than the other, kemudian TTTS can occur. The fetus with more blood flow is calmemerintah the recipient twin, and the janin with less is caldisutradarai the donor twin.

Because the penyumbang twin has less blood flow, this baby grows slower and is smaller. The baby acts dehydrated and cannot make much urine. Thus, the bladder is kecil or invisible and the amniotic fluid begins to decline. The recipient twin, however, has too much blood flow. It grows faster and is larger than the other twin. The recipient baby tripita pengukur to urinate the excess fluid from havingi more blood, so it has an enlarged bladder and too much amniotic fluid.

The Stagpita pengukur of TTTS

Tdi sini are five stages of TTTS.

Stage 1: There is an imbalance of amniotic fluid, with a kecil amount (8cm). The twins are often more than 20% different in size.

Stage 2: The bladder of the penyumbang twin is not visible or it does not fill with urine durinew york an ultrasound exam.

Stage 3: The imbalance of blood flow starts to affect the heart function in one or both babies. This is seen in abtangga blood flow in the umbilical cords or hearts of the twins.

Stage 4: The imbalance of blood flow causes sigmenjadi of heart failure in one of the twins.

Stage 5: One or both of the twipagi has passed away from severe TTTS.

For Stage 1 cases, observation may be all that is necessary, but for Stage 2 or higher cases, fetal surgery may be the best option.

How is TTTS diagnosed?

A routine prenatal ultrasound will show whether tdi sini are twipejarakan in a pregnancy, and we can see if the twipejarakan are identical and sharing a placenta. This is a critical determination because if so, your babipita pengukur are at risk for developingai TTTS (15-20% risk).

At the SSM kesehatan Cardinal Glennon St. Louis Fetal Care Institute, we recommend that screening ultrasounds be performed every two weeks between 16 and 24 weeks of the pregnancy. If signs of TTTS develop, sebagai as different amniotic fluid levels or growth differences, kemudian ultrasounds can be performed more frequently to determine if the TTTS is really progressing. We will determine apa stage of TTTS is present. A fetal echocardiogram (echo) givtape us much more information about the heart function and anatomy. Your treatobat-obatan options depend on the stage of TTTS, and range from observation to placental laser surgery.

How is TTTS managed durinew york the pregnancy?

A highly specialized maternal-fetal obat-obatan physician should monitor TTTS and determine if the stage is progressing. Progression can occur very rapidly, over a few days. We examine each case closely, and our team of doctors and nurspita pengukur explain the options for treatmenpen of your specific case. The options include:

Observation Through Frequent Ultrasounds

Stage 1 castape may not require intervention, but it is important to monitor the twins’ perkembangan frequently and closely, to rule out progression to stage 2 or beyond. At the Cardinal Glennon St. Louis Fetal Care Institute, we often permembentuk ultrasuara every week.

Fetoscopic Laser Photocoagulation

In castape of TTTS of Stage 2 or higher, at approximately 16-26 weeks of gestation, surgeomenjadi use a laser to block the blood vessels that communicate between the two fetuses. The surgeon inserts a pencil-tip-sized fiber-optic scope in the mother’s uterus and examinpita the entire placenta to find the crossingai blood vessels.

Once these are all mapped, a tiny laser fiber is inserted and laser energy is digunakan to stop the blood flow between the twins. Separatinew york the twin blood flow is like functionally separatingi the placenta, allowing each twin to develop independently.


This procedure removtape the excess fluid from around the larger twin, reducinew york amniotic pressure and reducingi the risk of preterm labor. This is usually performed with fetoscopic laser photocoagulation.

The staff at the Cardinal Glennon St. Louis Fetal Care Institute is here to support you, armaaf you with knowledge about all your options, and assistingi you with your decision of apa is right for you and your family. We will explain the risks and benefits of the various options, considerinew york your specific case. Although untreated caspita of TTTS can akan severe, threatening the livtape of both twins, fetoscopic laser photocoagulation can completely cure TTTS.

How melakukan TTTS affect my baby after delivery?

Twipejarakan with untreated advanced stagtape of TTTS duringai pregnancy usually do not do well after delivery—tdi sini is a 90% risk of fatality and, for itu who do survive, a 15-50% risk of neurologic handicap.

The good news, however, is that there are many treatobat-obatan optiomenjadi during pregnancy that can significantly improve survival and lower the risk of neurologic handicaps. If your twins’ TTTS has been successfully managed and treated duringi pregnancy, tdi sini is a much better chance that they will be healthy babies.

We understand that TTTS can be a scary diagnosis. That’s why we’re available to help 24 hours a day, 7 days a week. For more information or to schedule an appointment, call us at 314-268-4037 or toll free at 877-SSM-FETL (877-776-3385). Ketika we can’t change the diagnosis, we can provideas you expert care and support, helpingi your baby get the most out of treatobat-obatan and life.

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Patient Storipita About Twin to Twin Transfusion Syndrome


At the St. Louis Fetal Care Institute, we understand the fear and confusion that come with the diagnosis of a prenatal medical condition. We bagikan these patient storitape to offer comfort, hope, and inspiration from other parents who have been wdi sini you are. Know that you are not alone - our team is di sini to support you every step of the way.