Twin to Twin Transfusion Syndrome (TTTS) (TTTS)
It is a complication seen in monochorionic twins, that is, when the twins have a single placenta in common. It is not seen in dichorionic twin pregnancies, that is, twin pregnancies with separate placentas. It is a condition that occurs due to shared blood flow between the common placentas of babies. The baby with more blood flow is called the recipient baby, and the baby with less blood flow is called the donor baby. It occurs in about 15 percent of monochorionic twins. The risk of recurrence of IITS in subsequent pregnancies is extremely low.
Diagnosis:
Seeing the following conditions on ultrasound creates suspicion that IITS has developed:
- 20% of fetuses. There is a weight difference of more than 100,000
- There is a difference in size between the amniotic sacs
- There is a difference between the cord thicknesses
- There is a single placenta
- Signs of heart failure in the recipient fetus
- Polyhydramnios (too much water) in the recipient fetus, oligohydramnios (low water) in the donor fetus
- Same gender
- Large bladder in the recipient baby and small bladder in the donor baby
- Hydrops observed in one of the babies (fluid accumulation around the heart and lungs, fluid in the abdominal cavity, edema on the skin)
Serious oligohydramnios In cases where it is present, the donor fetus may stick to the uterine wall, this is called stuck twin syndrome.
Treatment:
For treatment, the baby's fluid, which has amniotic fluid, is removed as needed throughout pregnancy, that is, amnioreduction. process can be done. Tearing the amniotic membrane between babies with a needle (septostomy) is also a beneficial procedure by allowing the baby with low water to pass amniotic fluid. An attempt is made to prevent blood flow between babies by applying laser to the vessels connected to the placenta, accompanied by amnioscopy. Birth is performed when it is thought that the babies have completed the appropriate development.
Complications of twin-to-twin transfusion syndrome:
- Premature birth
- Breathing in babies, heart, kidney, brain and digestive system problems
- Donor baby Anemia in cases
- Death may occur in babies
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