12/02/2026
Twin-to-twin transfusion syndrome (TTTS)
is a serious, rare condition affecting 5–15% of identical twins sharing a placenta (monochorionic). It occurs when an imbalanced vascular connection causes one "donor" twin to transfer too much blood to the "recipient" twin
Without treatment, survival rates are below 10%, but specialized interventions like
laser surgery
significantly improve outcomes
Key Aspects of TTTS
Symptoms: Rapid weight gain, severe abdominal pain/tightness, and premature labor symptoms.
Diagnosis: Primarily via ultrasound between 16–26 weeks, showing a "stuck" (donor) twin with no amniotic fluid and a recipient twin with excessive fluid.
Treatments:
Fetoscopic Laser Ablation: The preferred treatment to seal connecting vessels.
Amnioreduction: Removing excess amniotic fluid.
Septostomy: Creating a hole in the membrane to balance fluid.
Survival Rate: With proper treatment, 66–85% of cases result in the survival of at least one twin.
Prevention: It cannot be prevented, but close monitoring (ultrasounds every 2 weeks from 16 weeks) ensures early detection.
The condition often leads to premature birth, but successfully treated babies usually live normal, healthy lives.
