Twin to Twin Transfusion Syndrome (TTTS) is a serious complication of twin and triplet pregnancies that occurs in 10-15% of twin pregnancies where the babies share the same placenta. Normally, while the placenta is shared, the blood supply for each baby is separate. With TTTS, blood from one baby can mix with the blood of the other baby through small connecting blood vessels in the placenta. If this blood is not shared equally between the babies, over time one of them begins to suffer from complications of too much circulating blood, while the other begins to suffer problems from not having enough. The baby with too much blood can develop complications such as heart failure (cardiomyopathy) and swelling (edema or fetal hydrops) and excess amniotic fluid (polyhydramnios). The baby with not enough blood can develop complications such as poor growth (intrauterine growth restriction), a lack of amniotic fluid (oligohydramnios) and other problems related to severe and prolonged blood loss (anemia).
In severe cases, if TTTS is not treated, there is a 60 to 100% chance that both babies can die in utero. Those babies who survive the pregnancy have a one in four risk of brain damage because of a lack of oxygen, blood and other nutrients. The pregnancy may also be lost because the uterus becomes over-distended from extra amniotic fluid. This condition may lead to premature labor or miscarriage. In less severe cases of TTTS the outcomes improve, however the majority of pregnancies are still very complicated and usually end prematurely.
There are 3 commonly offered treatment options for TTTS. The choice depends on the severity of the condition and your wishes as parents. These choices are:
Chances are, if you are viewing these web pages, your doctor has told you that laser photocoagulation may be helpful in your pregnancy.