Twin-to-twin

Twin-to-twin transfusion syndrome (TTTS) is a prenatal condition in which twins share unequal amounts of the placenta's blood supply resulting in the two fetuses developing at different rates. This condition is also known as feto-fetal transfusion syndrome (FFTS), twin oligohydramnios-polyhydramnios sequence (TOPS) and stuck twin syndrome.

Causes

TTTS is caused by abnormal connecting blood vessels in the twins' shared placenta. This results in blood from one twin (the donor twin) being pumped to the other (the recipient twin), through the shared blood vessels. The donor twin may end up with too little blood, and the recipient with too much.

Symptoms

Symptoms of TTTS may vary depending on the stage of the condition. The donor twin may be smaller, have less amniotic fluid and produce less urine. The recipient twin may have too much amniotic fluid and show signs of heart strain.

Diagnosis

TTTS can be diagnosed during pregnancy by using ultrasound. The ultrasound can show the size difference between the twins, the amount of amniotic fluid around each twin, and the presence of a shared placenta with abnormal blood vessels.

Treatment

Treatment options for TTTS include amnioreduction, laser therapy, and in severe cases, separation of the twins' blood vessels or delivery of the babies.

Prognosis

The prognosis for TTTS varies. Without treatment, the mortality rate for both twins is high. With treatment, the survival rate for at least one twin improves significantly.

See also

• Monochorionic twins
• Twin anemia-polycythemia sequence
• Twin reversed arterial perfusion

References

Twin-to-twin Resources
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