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Twin to twin transfusion syndrome (TTTS) is a serious disorder that occurs in identical twins and higher order multiples who share a placenta. This occurs when there is a connection in the two babies’ blood vessels of their shared placenta. This results in one baby (this twin is referred to as the recipient) receiving more blood flow, while the other baby (this twin is referred to as the donor) receives too little. Twin to twin transfusion syndrome is also referred to as chronic intertwin transfusion syndrome.

How often does Twin to Twin Transfusion Syndrome occur?

TTTS occurs about 15 percent of the time among identical twins. Fraternal twins are not at risk for this syndrome because they do not share a placenta.

What can I do to make sure my twins do not develop Twin to Twin Transfusion Syndrome?

TTTS is a random event that cannot be prevented by doing or not doing any specific thing. It is not a genetic disorder nor is it a hereditary condition.

How is Twin to Twin Transfusion Syndrome diagnosed?

Your healthcare provider may suspect this disorder if any of the following is seen during an ultrasound:

  • Marked difference in the size of fetuses of the same gender
  • Difference in size between the two amniotic sacs
  • Difference in size of the umbilical cords
  • A single placenta
  • Evidence of fluid build up in the skin of either fetus
  • Findings of congestive heart failure in the recipient twin
  • Polyhydraminos (excess amniotic fluid) in the recipient twin
  • Oligohydraminos (decreased or too little amniotic fluid) in the donor twin

Does the mother have any signs of Twin to Twin Transfusion Syndrome?

A mother whose twins have TTTS may experience:

  • Sensation of rapid growth of the womb
  • A uterus that measures large for dates
  • Abdominal pain, tightness, or contractions
  • Sudden increase in body weight
  • Swelling in the hands and legs in early pregnancy

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