What is twin to transfusion?

Twin-to-twin transfusion syndrome (TTTS) is a complication that can occur in some pregnancies with identical twins who share a placenta (monochorionic pregnancies). In TTTS, one twin (the "donor") pumps too much blood to the other twin (the "recipient") through the shared blood vessels in the placenta. This can lead to problems for both twins. The donor twin may develop anemia and/or growth restriction. The recipient twin may develop polycythemia and/or heart failure.

TTTS is a serious condition, but it can usually be treated successfully if it is diagnosed early. Treatment options may include:

- Amnioreduction: Removing some of the amniotic fluid from the recipient twin's amniotic sac. This can help to reduce pressure on the heart and lungs.

- Laser surgery: Using a laser to seal off some of the shared blood vessels in the placenta. This can help to stop blood from flowing from the donor twin to the recipient twin.

- Delivery: In some cases, delivery may be the best option if TTTS is severe or if treatment is not successful.

Signs and symptoms of TTTS may include

- Excessive growth of one twin and restricted growth of the other

- Too much amniotic fluid (polyhydramnios) in the sac of the recipient twin

- Too little amniotic fluid (oligohydramnios) in the sac of the donor twin

- A difference in the heart rates of the twins

- Signs of heart failure in the donor twin such as swelling, increased respiratory rate, and pale skin

-Signs of polycythemia in the recipient twin such as red skin and irritability

If you are pregnant with identical twins and you have any concerns about TTTS, talk to your doctor right away.