The twin to twin transfusion syndrome occurs frequently in the second trimester of pregnancy, ignore this situation can lead to fetal death of one or both fetuses. Twintotwin transfusion syndrome ttts is the result of an intrauterine blood transfusion from one twin donor to another twin recipient. The most important lesson from 83,000 brain scans daniel amen tedxorangecoast duration. Of these, 11 pairs had fetofetal transfusion syndrome. Herrera r ginecologia obstetricia medicina materno fetal. Further evidence of fetal compromise was the detection of abnormal fetal heart pattern and ctg showing reduced beat to beat variability and very small decelerations. Twintwin transfusion syndrome ttts cincinnati fetal. If your twins have ttts, one baby will receive too much blood and. Twintotwin transfusion syndrome clinical presentation. Twintwin transfusion syndrome ttts is a rare, serious condition that can occur in pregnancies when identical twins share a placenta.
A more subtle form of fetal hemorrhage was suggested by weiner, 2 who postulated that transplacental bleeding. Out of 42 pairs of liveborn monochorial twins there were 32 pairs with vascular anastomoses. Fetofetal transfusion syndrome contributes heavily to high rates of perinatal mortality and morbidity in monochorionic multiple pregnancies. Twintotwin transfusion syndrome abstract twin to twin transfusion syndrome is one of the most serious complications on multiple pregnancy which deserves a strict monitoring. There were another 8 pairs of stillborn twin fetuses with vascular communications and in these chronic fetofetal transfusion syndrome might have resulted in intrauterine death. Twintwin transfusion syndrome ttts occurs in approximately 10%15% of all monochorionic diamniotic twin pregnancies, develops typically between 15 and 26 weeks of gestation and is associated with a high perinatal morbidity and mortality1,2,3. Ttts only occurs in monozygotic identical twins with a monochorionic placenta. Management of fetofetal transfusion syndrome robyr. Management of twintwin transfusion syndrome in monochorionic twin gestations. Abnormal blood vessel connections form in the placenta and allow blood to flow unevenly between the babies.
One of the products was an acardic and acephalic fetus, an unusual condition, which occurs in monochorionic twin pregnancies, who share vascular placental anastomosis. Twin to twin transfusion syndrome fetofetal transfusion. Fetomaternal transfusion as a cause of severe fetal anemia. Fetomaternal transfusion as a cause of severe fetal anemia causing early neonatal death. Twintotwin transfusion syndrome ttts, also known as fetofetal transfusion syndrome ffts, twin oligohydramniospolyhydramnios sequence tops and. Diagnosi e trattamento della trasfusione feto fetale tts.
Its prenatal management has been controversial for at least 25 years. Fetomaternal transfusion jama pediatrics jama network. Fetofetal transfusion, more commonly known as twin to twin transfusion syndrome ttts, is a very serious prenatal complication. Purpose transfusions are given to restore lost blood, to improve clotting time, and to improve the ability of the blood to deliver oxygen to the bodys tissues.