Question: How is TTTS (Twin-to-Twin Transfusion Syndrome) Treated?
Twin-to-Twin Transfusion Sydrome is a disorder that impacts about ten percent of monozygotic (identical) twin pregnancies. Find more answers to Frequently Asked Questions About TTTS.
Answer: Once TTTS (Twin-to-Twin Transfusion Syndrome) is detected (see How is TTTS Diagnosed?), the course of treatment will be determined by the stage of the disease and the timing of the pregnancy. According to the TTTS Foundation, Chronic TTTS is definied as "those cases that appear early in pregnancy (12-26 weeks’ gestation). These cases are the most serious because the babies are immature and cannot be delivered." while Acute TTTS "describes those cases that occur suddenly, whenever there is a major difference in the blood pressures between the twins. This may occur in labor at term, or during the last third of pregnancy whenever one twin becomes gravely ill or even passes away as a result of the abnormalities in their shared placenta."
The only "cure" for TTTS is delivery. Doctors have to weigh the impact of delivering the babies prematurely, and consider the difficult question, "Are they better off in the womb or out?" They may prescribe bedrest and even hospitalization in order to closely monitor the situation and stave off preterm labor until the babies are viable (usually after 28 weeks gestation). Sometimes, an intervention to remove excess amniotic fluid from the recipient baby will be performed to stabilize the situation.
However, within the last ten years, medical technology has made it possible to correct the malformed blood vessels in the placenta by using a laser. Fetoscopic laser coagulation allows a surgeon to see inside the womb through a tiny incision, and seal off the connected blood vessels with a laser.
According to Texas Children's Hospital, one of the leading medical centers in the U.S. for diagnosing and treating TTTS and other fetal abnormalities, "laser ablation has a success rate of up to 80% of one of more of the twins surviving." The technology involves local anesthesia, one small incision and an operating time of 45 minutes to 2 hours.
For an in-depth description of the treatment options for TTTS, please visit Texas Children's Hospital's website.
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Got a question that's not answered here? Email me at multiples.guide@about.com.
The only "cure" for TTTS is delivery. Doctors have to weigh the impact of delivering the babies prematurely, and consider the difficult question, "Are they better off in the womb or out?" They may prescribe bedrest and even hospitalization in order to closely monitor the situation and stave off preterm labor until the babies are viable (usually after 28 weeks gestation). Sometimes, an intervention to remove excess amniotic fluid from the recipient baby will be performed to stabilize the situation.
However, within the last ten years, medical technology has made it possible to correct the malformed blood vessels in the placenta by using a laser. Fetoscopic laser coagulation allows a surgeon to see inside the womb through a tiny incision, and seal off the connected blood vessels with a laser.
According to Texas Children's Hospital, one of the leading medical centers in the U.S. for diagnosing and treating TTTS and other fetal abnormalities, "laser ablation has a success rate of up to 80% of one of more of the twins surviving." The technology involves local anesthesia, one small incision and an operating time of 45 minutes to 2 hours.
For an in-depth description of the treatment options for TTTS, please visit Texas Children's Hospital's website.
Return to the FAQ Index
Got a question that's not answered here? Email me at multiples.guide@about.com.
