Twin-to-Twin Transfusion Syndrome

you
you
if you're pregnant with twins who have
twin-to-twin transfusion syndrome blood
is passing from one twin to the other
inside your uterus your fetus receives
blood through blood vessels in the
umbilical cord connected to his or her
belly button
the other end of the umbilical cord is
attached to the placenta a temporary
organ inside your uterus
the outer layer of the placenta called
the chorion contains many blood vessels
that carry blood to and from the
umbilical cord
the fetus floats in a watery substance
called amniotic fluid
surrounding both the fee
and amniotic fluid is a thin membrane
called the amniotic sac
if you're pregnant with twins they may
share amniotic fluid because they're
both in the same sac
or each twin might have his or her own
amniotic sac
these twins may each have their own
placenta
or they might share a single placenta
sometimes when twins share a placenta
blood passes between them through the
placentas blood vessels
this rare condition is called twin to
twin transfusion syndrome or TTTS
in twin-to-twin transfusion syndrome one
twin called the recipient twin receives
too much blood while the other twin
called the donor twin receives too
little when this happens the excess
fluid and the recipient Twins blood is
filtered out of his or her body as urine
the urine passes into the amniotic sac
which makes the sac larger twin-to-twin
transfusion syndrome happens in only a
small fraction of identical twins that
share a single placenta it is also a
rare complication with triplets or any
other multiple pregnancy the cause is
not known complications that may result
from twin to twin syndrome are preterm
birth
a condition called hydrops which is
swelling of one or both of the twins
or death of one or both of the twins
in addition one or both twins may
develop cerebral palsy or other brain
impairments after birth
treatment options for twin to twin
transfusion syndrome include reduction
amniocentesis
selective laser ablation
or selective chord coagulation
if you have reduction amniocentesis a
needle will be used to drain fluid from
around the twin with excess amniotic
fluid this procedure may need to be
repeated during selective laser ablation
the blood vessels that allow blood to
pass between the twins will be sealed
off with a laser if you have selective
chord coagulation one of the umbilical
cords will be closed off with electrical
current or a laser this is performed
when laser ablation is not possible or
when one of the twins is not expected to
survive
if you have a concern about twin-to-twin
transfusion syndrome in your pregnancy
seek care at an experienced tertiary
center your obstetrician may be able to
provide you with a referral