Twin-twin transfusion syndrome (TTTS) is a rare, serious condition that can occur in pregnancies when identical twins share a placenta. Abnormal blood vessel connections form in the placenta and allow blood to flow unevenly between the babies. One twin − called the donor – becomes dehydrated; and the other − called the recipient − develops high blood pressure and produces too much urine and over fills the amniotic sac.  

TTTS is a disease of the placenta, not the babies themselves, and affects each twin differently. The donor twin, who is becoming dehydrated, does not produce as much urine as it should, resulting in a low amount of amniotic fluid and poor fetal growth. The recipient twin, whose system is overwhelmed by too much fluid, produces more urine than usual. This eventually leads to an enlarged bladder and excess amniotic fluid. The excess fluid can put a strain on the recipient twin’s heart, sometimes leading to heart failure. 

Prognosis for Twin-Twin Transfusion Syndrome

Without treatment, this condition can be fatal for both twins. Fetal surgery is sometimes necessary to save one or both babies. The prognosis is usually better when the condition develops after 20 weeks’ gestation.  

Receiving a diagnosis of twin-twin transfusion syndrome is an emotional experience, and in some cases decisions about treatment must be made quickly. At the Cincinnati Fetal Center, we are here to help, providing a thorough, compassionate approach to each patient’s care.  

Expert, Compassionate Care for TTTS 

Our experienced maternal and fetal care specialists offer a complete range of diagnostic tests and treatment options. Surgeons at the Fetal Center have performed more than 1,061* fetal surgeries for TTTS since 2004. Our center is among only a handful of centers that can offer surgical interventions for triplet pregnancies affected by this condition and for patients who have an anterior placenta. An anterior placenta is positioned toward the front of the mother’s womb, and its location increases the technical difficulty of surgery.  

*Data based on patients cared for by the Cincinnati Fetal Center from Feb. 1, 2004, through June 30, 2017.