How is twin to twin transfusion treated?

Are you an expectant mother with a twin pregnancy? Congratulations, that’s double the excitement! But what if one of your twins starts hogging all the nutrients meant for both babies? That’s when we have a medical condition called “Twin to Twin Transfusion Syndrome (TTTS).” Sounds scary, right? It indeed is concerning but don’t worry; there are treatment options available.

What is TTTS?

Allow me to break down this complicated term for you. When it comes to multiple pregnancies, they share their resources among themselves. In some cases, blood transfuses disproportionately from one twin (donor) than the other (recipient). This movement of blood can cause severe problems like premature birth or stillbirth.

What causes TTTS?

The exact reason why this happens isn’t clear yet. However, doctors believe it occurs when identical monochorionic twins share a single placenta(monochorionic-diamniotic) during early stages of pregnancy.


It would help if you went through frequent checkups and ultrasounds throughout your pregnancy—usually every four weeks in case of monochorionic twins pregnancies since there are high chances TTTS might develop after 20 weeks.


You might experience swelling and rapid weight gain if you’ve developed TTTS syndrome. Also, your belly may seem more prominent than usual as amniotic fluid might accumulate around the recipient baby because their heart has a tough time pumping excessive fluid supplied by the donor sibling.

Remember to keep track of these symptoms while pregnant!

Treatment Options Available

Your primary goal should be maintaining good health throughout gestation by monitoring food intake regularly and keeping yourself hydrated. Other steps followed once diagnosed includes:

Expectant management

Also known as “watchful waiting.” We start with monitoring both fetuses’ growth via serial ultrasound scans since TTTS development might not occur in all cases. This method inspects the presence of excess amniotic fluid and other critical parameters like bladder visualization, femur length, umbilical cord flow,etc.

Laser ablation therapy

Laser ablation precisely identifies and treats the blood vessels sharing between your twins that are causing unequal distribution of nutrients by cutting them off so that they cannot deliver blood transfusions back.

The Procedure

We will need to make small incisions on the mother’s abdomen under localized or general anesthesia depending on various factors such as gestational age, maternal anatomy, etc. A tiny fiber-optic camera (endoscope) is inserted into one incision along with a laser through another to identify abnormal connections present in fetal placenta circulation selectively cut them using laser energy carefully.

After surgery, we observe for twin movements very closely via ultrasound scans within two weeks since this procedure carries some potential risks too.


This process removes excessive amniotic fluid from around the recipient baby by positioning needles through your belly under ultrasound guidance regularly until birth but often recommended in specific cases up until 36 weeks’ gestation only following monitoring conditions have met:

  • Recipient TFVS >8 cm
  • Maximum vertical depth of deepest PST >10 cm
  • Hydropic changes

Other treatment options exist; however, consulting an expert before making decisions about undergoing invasive therapies would be wise.

Risks Involved In Treatment Options?

Like any medical intervention, these procedures carry certain risks such as premature delivery due to trauma from invasive surgeries performed during pregnancy despite clear advantages surgically treating severe stages of TTTS syndrome preserves lives and potentially reduces complications caused at later stages.

In conclusion,
As mentioned earlier even though it’s always better to take precautions than undergo life-threatening treatments it’s great knowing there are advanced technologies available if things go wrong unexpectedly can be reassuring. Remember to take care of your health and follow the expert’s instructions. Stay safe, healthy happy, and enjoy these precious moments with both your lovely little ones to-be!

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