Understanding Twin-to-Twin Transfusion syndrome
Twin-to-twin transfusion syndrome (TTTS) is a condition that can occur in identical twin pregnancies when the babies share a single placenta. Because their blood vessels are connected, one twin may receive too much blood (the “recipient”), while the other receives too little (the “donor”). This imbalance can cause health problems for both babies if not monitored and treated. TTTS is not caused by anything the parents did, and doctors use special ultrasounds to watch for it closely and offer treatment when needed.
Fetal Center: The first step in TTTS care
Multidisciplinary Evaluation: meet with MFM specialist, neonatologist, and other experts who will care for your baby
Comprehensive Imaging: detailed ultrasounds and other tests when indicated to assess your baby's condition and help plan treatment
Coordinated Delivery Planning: our team works to ensure your baby receives immediate specialized care at birth
How is TTTS Evaluated?
TTTS is usually found during routine monitoring of the pregnancy. Because it can change and become more severe over time, we evaluate the babies on a frequent basis:
- Regular specialized ultrasounds are used to check each baby’s growth, the amount of amniotic fluid around them, and how their shared placenta is functioning.
- Fluid levels are compared—too much around one twin and too little around the other can signal TTTS.
- Bladder visibility in each baby is assessed, since the donor twin may have a small or hard-to-see bladder.
- Blood flow studies (Dopplers) help doctors look at how blood is moving through the babies’ umbilical cords and hearts.
- Staging the condition (using a standard TTTS scale) helps determine how serious it is and whether treatment is needed.
We perform laser ablation for TTTS in Utah!
If TTTS becomes severe enough, our team, using a fetoscope, under ultrasound guidance, can identify the vessels connecting the blood supply on the placenta resulting in TTTS and close them using a laser. This can result in a significant increase in survivability of both twins without neurologic problems.
Dr. Martha Monson, a Maternal Fetal Medicine Interventionalist, and Jenn Mallett, a fetal ultrasound technologist, at our annual fetal family reunion with some of our twins treated for TTTS.
