Condition 101 About Twin-To-Twin Transfusion Syndrome

What is the definition of Twin-To-Twin Transfusion Syndrome?

Twin-to-twin transfusion syndrome is a rare condition that occurs only in identical twins while they are in the womb.

What are the alternative names for Twin-To-Twin Transfusion Syndrome?

TTTS; Fetal transfusion syndrome

What are the causes for Twin-To-Twin Transfusion Syndrome?

Twin-to-twin transfusion syndrome (TTTS) occurs when the blood supply of one twin moves to the other through the shared placenta. The twin that loses the blood is called the donor twin. The twin that receives the blood is called the recipient twin.

Both infants may have problems, depending on how much blood is passed from one to the other. The donor twin may have too little blood, and the other may have too much blood.

What are the symptoms for Twin-To-Twin Transfusion Syndrome?

Most of the time, the donor twin is smaller than the other twin at birth. The infant often has anemia, is dehydrated, and looks pale.

The recipient twin is born larger, with redness to the skin, too much blood, and a higher blood pressure. The twin that gets too much blood may develop cardiac failure because of the high blood volume. The infant may also need medicine to strengthen heart function.

The unequal size of identical twins is referred to as discordant twins.

What are the current treatments for Twin-To-Twin Transfusion Syndrome?

Treatment may require repeated amniocentesis during pregnancy. Fetal laser surgery may be done to stop the flow of blood from one twin to the other during pregnancy.

After birth, treatment depends on the infant's symptoms. The donor twin may need a blood transfusion to treat anemia.

The recipient twin may need to have the volume of body fluid reduced. This may involve an exchange transfusion.

The recipient twin may also need to take medicine to prevent heart failure.

What is the outlook (prognosis) for Twin-To-Twin Transfusion Syndrome?

If the twin-to-twin transfusion is mild, both babies often recover fully. Severe cases may result in the death of a twin.

REFERENCES

Malone FD, D'alton ME. Multiple gestation: clinical characteristics and management. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 40.

Newman RB, Unal ER. Multiple gestations. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 32.

Obican SG, Odibo AO. Invasive fetal therapy. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 37.

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Latest Advances On Twin-To-Twin Transfusion Syndrome

  • Condition: Twin-Twin Transfusion Syndrome (TTTS)
  • Journal: Biomedical journal
  • Treatment Used: Laser Treatment
  • Number of Patients: 93
  • Published —
This study examined the incidence of elevated liver enzymes (ELEzs) before laser therapy and the association with the perinatal outcomes after laser therapy in patients with twin-twin transfusion syndrome (TTTS).
  • Condition: Depressive Symptoms in Pregnancies Complicated by Twin-Twin Transfusion Syndrome (TTTS)
  • Journal: BMC pregnancy and childbirth
  • Treatment Used: Psychological Support
  • Number of Patients: 27
  • Published —
This study assessed antenatal and postnatal parental attachment and depressive symptoms in those with pregnancies affected by twin-twin transfusion syndrome (TTTS).

Clinical Trials For Twin-To-Twin Transfusion Syndrome

Clinical Trial
  • Status: Recruiting
  • Participants: 1000
  • Start Date: May 1, 2017
Austrian Registry on the Outcome of Monochorionic Multiple Pregnancies: A Multicenter Registry Study