Twin to twin transfusion syndrome (TTTS) is a rare condition but also a serious one. This condition happens when the identical twins share the same placenta. When this happens then the blood vessel connections get abnormal and it causes the blood to not flow evenly between both the babies. One of the twins who are the donor becomes dehydrated and the other twin who is the recipient gets a high blood pressure. The second twin produces lots of urine that fills up the amniotic sac.
TTTS is a disease that gets formed in the placenta of the pregnant woman and thus this is not a disease that occurs in the babies. The condition affects the twins in different ways. The twin who is the donor does not produce sufficient quantities of urine and thus has low amniotic fluid levels which lead to low growth. The second twin or the recipient twin has too much fluid and this twin produces more urine. This causes a big bladder and the recipient twin has an excess of amniotic fluid. The excess of the amniotic fluid at times puts a lot of pressure on the heart and this could cause heart failure.
The condition needs to be treated immediately else it could be fatal for both the babies. Doctors would ask the pregnant woman to opt for fetal surgery to be able to save both the babies or at least one of them.
TTTS- diagnosis, and evaluation
The doctor first checks the symptoms A fetal monitor or ultrasound is done to know how severe the condition is and once the condition gets confirmed a treatment plan is put in place.
These are the five stages of the TTTS condition.
- A lot of difference in the volume of the amniotic fluid in each of the twin’s sac
- Difficulty in being able to see the bladder of the smaller baby
- Abnormal flow of blood through the umbilical cord or the fetal vessels
- An abnormal accumulation of fluid of more than one of the body cavity of either of the baby
- Death of one or both the babies
During the diagnosis, the severity of the condition of the heart is checked.
The treatment plan is based on how severe the condition is. The treatment plans are:
- Expectant management or monitoring the pregnancy which is done if the condition is less severe
- Amnioreduction or draining excess amniotic-fluid is done when the condition is mild
- Selective Fetoscopic Laser Photocoagulation (Laser Surgery)is done when the condition is very severe.
It is important that the condition of TTTS is diagnosed early and treated fast so that it can save the lives of the twins. The best available treatment is dependent on the stages of the TTTS condition and the diagnosis time. If the condition is not treated then it is highly probable that the twins will die. Therefore it is crucial that if the mother is carrying twins then the screening for TTTS is done as early as possible.
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