Twin-To-Twin Transfusion SyndromeSymptoms, Doctors, Treatments, Advances & More
Learn About 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.
TTTS; Fetal 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.
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.
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, the 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.
Dell Children's Medical Group - Comprehensive Fetal Care Center North
Michael Bebbington is a Neonatologist practicing medicine in Austin, Texas. Dr. Bebbington is rated as an Elite provider by MediFind in the treatment of Twin-To-Twin Transfusion Syndrome. He is also highly rated in 3 other conditions, according to our data. His clinical expertise encompasses Twin-To-Twin Transfusion Syndrome, Myelomeningocele, Anemia, Diaphragmatic Hernia, and Endoscopy. Dr. Bebbington is board certified in The American Board Of Obstetrics And Gynecology - Maternal And Fetal Medicine and The American Board Of Obstetrics And Gynecology - Obstetrics And Gynecology. Dr. Bebbington is currently accepting new patients.
Dell Children's Medical Group - Comprehensive Fetal Care Center Pavilion
Kenneth Moise is a Neonatologist practicing medicine in Austin, Texas. Dr. Moise is rated as an Elite provider by MediFind in the treatment of Twin-To-Twin Transfusion Syndrome. He is also highly rated in 10 other conditions, according to our data. His clinical expertise encompasses Twin-To-Twin Transfusion Syndrome, Hemolytic Disease of the Newborn, Myelomeningocele, Anemia, and Endoscopy. Dr. Moise is board certified in The American Board Of Obstetrics And Gynecology - Maternal And Fetal Medicine and The American Board Of Obstetrics And Gynecology - Obstetrics And Gynecology. Dr. Moise is currently accepting new patients.
The Johns Hopkins Hospital
Ahmet Baschat is a Neonatologist practicing medicine in Baltimore, Maryland. Dr. Baschat is rated as an Elite provider by MediFind in the treatment of Twin-To-Twin Transfusion Syndrome. He is also highly rated in 17 other conditions, according to our data. His clinical expertise encompasses Twin-To-Twin Transfusion Syndrome, Intrauterine Growth Restriction, Bilateral Renal Agenesis Dominant Type, Diaphragmatic Hernia, and Endoscopy. Dr. Baschat is board certified in American Board Of Obstetrics And Gynecology. Dr. Baschat is currently accepting new patients.
If the twin-to-twin transfusion is mild, both babies often recover fully. Severe cases may result in the death of a twin.
Summary: Each year world-wide, 2.5 million fetuses die unexpectedly in the last half of pregnancy, 25,000 in the United States, making fetal demise ten-times more common than Sudden Infant Death Syndrome. This study will apply a novel type of non-invasive monitoring, called fetal magnetocardiography (fMCG) used thus far to successfully evaluate fetal arrhythmias, in order to discover potential hidden elect...
Summary: The purpose of this study is to evaluate whether the entry technique surgeons use to get inside the uterus to perform fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome has an effect on the rates of chorioamniotic membrane separation.
Published Date: August 18, 2025
Published By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Khalil A, Mustafa HJ. Multiple gestations. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 9th ed. Philadelphia, PA: Elsevier; 2025:chap 39.
Malone FD, D'Alton ME. Multiple gestation: clinical characteristics and management. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 37.
Obican SG, Odibo AO. Invasive fetal therapy. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 34.