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Twin-to-Twin Transfusion Syndrome (TTTS)

A serious complication of monochorionic twin pregnancies caused by placental anastomoses.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

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

Twin-to-twin transfusion syndrome is a serious complication that develops in approximately 10-15% of monochorionic diamniotic twin pregnancies. A net flow of blood occurs from the donor twin to the recipient twin through arteriovenous anastomoses in the placenta.

The donor twin develops hypovolemia, oligohydramnios, anhydramnios and growth restriction, while the recipient twin shows hypervolemia, polyhydramnios, heart failure, hydrops and polycythemia. The Quintero staging system (I-V) defines the severity of the disease.

Serial ultrasound is used for diagnosis and monitoring; amniotic fluid discordance, bladder filling differences and Doppler findings are evaluated. Fetoscopic laser ablation is the gold standard treatment, with serial amnioreduction as an alternative method.

Symptoms

Rapid increase in uterine size
Severe abdominal distension and dyspnea
Significant size difference between twins on ultrasound
Polyhydramnios around the recipient fetus
Oligohydramnios around the donor fetus
Signs of preterm labor

Risk Factors

Monochorionic diamniotic twin pregnancy
Assisted reproductive techniques
Monoamniotic pregnancy sharing a single placenta
Presence of placental arteriovenous anastomoses
Previous history of TTTS
Irregular antenatal follow-up

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When significant abdominal enlargement occurs in monochorionic twin pregnancy
  • When amniotic fluid discordance is detected on ultrasound
  • When there is a significant size difference between twins
  • When signs of preterm labor develop
  • When changes in fetal movements are felt

Treatment Methods

01
Serial transabdominal ultrasound monitoring
02
Treatment planning according to Quintero stage
03
Fetoscopic laser ablation
04
Serial amnioreduction (in selected cases)
05
Selective feticide (in severe cases)
06
Delivery planning with the perinatology team

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.