Twin to twin transfusion syndrome

Twin to twin transfusion syndrome is a serious disease that occurs in identical twins and higher-order twins who share the same placenta. This happens when the blood vessels in the common placenta of babies join together.

As a result, one child (this twin is called the recipient) receives more blood, and the other child (this twin is called the donor) receives too little. Twin to twin transfusion syndrome is also called chronic inter-twin transfusion syndrome.

twin to twin transfusion syndrome occurs in approximately 15% of cases in identical twins. Fraternal twins are not at risk for this syndrome because they do not share a placenta.

What can I do to make sure my twins do not develop twin to twin transfusion syndrome?

Twin to twin transfusion syndrome is a random event that cannot be avoided by doing or not doing something specific. This is not a hereditary disease.

How is twin to twin transfusion syndrome diagnosed?

Your doctor may suspect this disorder if any of the following are found on an ultrasound:

A marked difference in the size of fetuses of the same gender
The difference in size between the two amniotic sacs
The difference in the size of the umbilical cords
A single placenta
Evidence of fluid build up in the skin of either fetus
Findings of congestive heart failure in the recipient twin
Polyhydramnios (excess amniotic fluid) in the recipient twin
Oligohydramnios (decreased or too little amniotic fluid) in the donor twin

A mother whose twins have twin to twin transfusion syndrome may experience:

A sensation of the rapid growth of the womb
A uterus that measures large for dates
Abdominal pain, tightness, or contractions
A sudden increase in body weight
Swelling in the hands and legs in early pregnancy

What treatment options are available for twin to twin transfusion syndrome?

Until recently, twin to twin transfusion syndrome claimed the lives of both babies, but technology has brought two new treatment options for the condition.

The use of amniocentesis to drain excess fluid appears to improve blood flow through the placenta and reduce the risk of preterm birth.

Amniocentesis can save about 60% of affected children. Laser surgery can also be used to seal the connection between blood vessels and appears to save 60% of affected children.

Delivery is also possible if your healthcare provider determines that the lungs of the twins have reached maturity.

What are the advantages of laser surgery instead of amniocentesis?

Amniocentesis may be required several times throughout pregnancy to maintain proper blood flow to the placenta, while laser surgery usually only requires one procedure.

What are the potential complications of twin to twin transfusion syndrome?

Premature labor either due to ruptured membranes or induction
Respiratory, digestive, heart, or brain defects in the recipient twin because of excess fluids
Donor twin developing anemia
Fetal demise/death