What Is Twin-to-Twin Transfusion Syndrome (TTTS)?

How often are we intrigued and amazed by the sight of identical twins? Little do we know how often identical twins don’t survive pregnancy or birth due to a deadly complication called Twin-to-Twin Transfusion Syndrome. TTTS kills more babies every day than SIDS, yet hardly anyone outside the twins community has heard about this potentially fatal condition. Here is a description of TTTS by the Fetal Hope Foundation:

TTTS or Twin-to-Twin Transfusion Syndrome is a disease of the placenta. It affects pregnancies with monochorionic (shared placenta) multiples when blood passes disproportionately from one baby to the other through connecting blood vessels within their shared placenta. One baby, the recipient twin, gets too much blood overloading his or her cardiovascular system, and may die from heart failure. The other baby, the donor twin or stuck twin, does not get enough blood and may die from severe anemia. Left untreated, mortality rates near 100%.

The cause of TTTS is attributed to unbalanced flow of blood through vascular channels that connect the circulatory systems of each twin via the common placenta. The shunting of blood through the vascular communications leads to a net flow of blood from one twin (the donor) to the other twin (the recipient). The donor twin develops oligohydramnios (low amniotic fluid) and poor fetal growth, while the recipient twin develops polyhydramnios (excess amniotic fluid), heart failure, and hydrops. If left untreated, the pregnancy may be lost due to lack of blood getting to the smaller twin, fluid overload and heart failure in the larger twin, and/or preterm (early) labor leading to miscarriage of the entire pregnancy.

One in 7 pregnancies with identical twins is afflicted with TTTS. Before the condition could be diagnosed by ultrasound, less than 10 percent of TTTS twins survived. Those who did survive were often greatly impaired. Now the odds of survival have significantly improved through medical intervention during pregnancy and after birth. Many parents of TTTS twins (as well as those parents who have lost twins from this condition) have benefited greatly from support groups. Two such organizations are the Twin to Twin Transfusion Syndrome Foundation at www.tttsfoundation.org and the Fetal Hope Foundation at www.fetalhope.org.

Please take a moment to watch this moving slide slow about a couple’s journey through TTTS: http://www.ssmpfiles.com/ourtttsjourney/index.html.