What Is Twin-to-Twin Transfusion Syndrome (TTTS)?

How often are we intrigued and amazed by the sight of identical twins? Little do we know how often identical twins don’t survive pregnancy or birth due to a deadly complication called Twin-to-Twin Transfusion Syndrome. TTTS kills more babies every day than SIDS, yet hardly anyone outside the twins community has heard about this potentially fatal condition. Here is a description of TTTS by the Fetal Hope Foundation:

TTTS or Twin-to-Twin Transfusion Syndrome is a disease of the placenta. It affects pregnancies with monochorionic (shared placenta) multiples when blood passes disproportionately from one baby to the other through connecting blood vessels within their shared placenta. One baby, the recipient twin, gets too much blood overloading his or her cardiovascular system, and may die from heart failure. The other baby, the donor twin or stuck twin, does not get enough blood and may die from severe anemia. Left untreated, mortality rates near 100%.

The cause of TTTS is attributed to unbalanced flow of blood through vascular channels that connect the circulatory systems of each twin via the common placenta. The shunting of blood through the vascular communications leads to a net flow of blood from one twin (the donor) to the other twin (the recipient). The donor twin develops oligohydramnios (low amniotic fluid) and poor fetal growth, while the recipient twin develops polyhydramnios (excess amniotic fluid), heart failure, and hydrops. If left untreated, the pregnancy may be lost due to lack of blood getting to the smaller twin, fluid overload and heart failure in the larger twin, and/or preterm (early) labor leading to miscarriage of the entire pregnancy.

One in 7 pregnancies with identical twins is afflicted with TTTS. Before the condition could be diagnosed by ultrasound, less than 10 percent of TTTS twins survived. Those who did survive were often greatly impaired. Now the odds of survival have significantly improved through medical intervention during pregnancy and after birth. Many parents of TTTS twins (as well as those parents who have lost twins from this condition) have benefited greatly from support groups. Two such organizations are the Twin to Twin Transfusion Syndrome Foundation at www.tttsfoundation.org and the Fetal Hope Foundation at www.fetalhope.org.

Please take a moment to watch this moving slide slow about a couple’s journey through TTTS: http://www.ssmpfiles.com/ourtttsjourney/index.html.

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About Susan Heim

Susan M. Heim is an author and editor, specializing in multiples, parenting, women’s and Christian issues. Her books include "Boosting Your Baby's Brain Power"; "Chicken Soup for the Soul: Twins and More"; "It’s Twins! Parent-to-Parent Advice from Infancy Through Adolescence"; "Twice the Love: Stories of Inspiration for Families with Twins, Multiples and Singletons"; and, "Oh, Baby! 7 Ways a Baby Will Change Your Life the First Year." Upcoming books include "Chicken Soup for the Soul: All in the Family," "Chicken Soup for the Soul: Devotional Stories for Women," and "Moms of Multiples' Devotions to Go." Susan's articles and essays have appeared in many books, magazines and Web sites. She is a member of the National Association of Women Writers and the Southeastern Writers Association, and has a degree in Business Administration from Michigan State University. Susan lives with her husband and four sons (two teenagers and twin grade-schoolers) in Florida.

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  1. It’s wonderful to see more about TTTS out there now. My grandsons are TTTS survivors. My daughter was diagnosed at 19 weeks, after months of bedrest at home and in the hospital she delivered the boys at 34 1/2 weeks weighing 4 lbs 2 ozs and 4 lbs 10 ozs. They are now healthy and happy at 6 months old. We thank god, the doctors and everyone else we can think of everyday for our little survivors. There is hope!! As recommended she drank boost until she was sick of it along with strict bedrest. She was given the option of terminating the pregnancy when she was diagnosed. She was positive throughout her pregnancy and went through it week by week at the beginning and then day by day!

  2. Pam Snyder says:

    I went through TTTS myself about 9 years ago. It was the worst thing I have ever had to deal with my whole life and will be an experience that I will never be able to forget. I lost both of my boys at 5 1/2 months of pregnancy. I am happy as well that it is being talked about more today so that there can be better help for people who have to go through such an awful experience. If you are reading this, please go to the twin to twin transfusion foundation website and make a donation so that they can do more research on this and help people be able to keep their babies. Thank you so much!