Twin-twin transfusion syndrome treatment
Treatment for twin-twin transfusion syndrome may include any of the following:
- Expectant management – In situations where surgery is not yet indicated (Stage 1 without additional risk factors), close monitoring with periodic ultrasound examinations is employed to assess the condition of both twins and identify signs of progression. In some cases, a follow-up fetal echocardiogram is also used to look for signs of cardiac changes, which may sometimes be detected before other changes.
- Fetoscopic selective laser ablation – A minimally invasive surgery performed on the placenta to disconnect the communicating blood vessels. This procedure, also known as selective laser photocoagulation (SLPC), prevents the exchange of blood between the donor and the recipient, aiming to halt the progression and ultimately resolve the twin-twin transfusion syndrome. This is typically the preferred treatment for TTTS, depending on the gestational age at presentation, the location of the placenta, and the stage of TTTS.
- Amnioreduction – Removal of excess amniotic fluid from the larger twin (recipient), which may help ease any pain or discomfort experienced by the mother due to fluid buildup. This is a temporary treatment option and may need to be repeated.
- Selective cord occlusion – A minimally invasive surgery that stops the blood flow to one twin to maximize the outcome for the other twin. Selective cord occlusion procedures include radiofrequency ablation (RFA) and bipolar cord coagulation (BCC). This is considered a last resort option when the disease is very advanced and the at-risk twin is not going to survive. This intervention can protect the co-twin from neurologic impairment and/or death.
Mothers undergoing a fetal surgery procedure will stay in our Garbose Family Special Delivery Unit, the first birthing unit within a pediatric hospital dedicated to healthy mothers carrying babies with serious and life-threatening birth defects.
Watch our educational video series to learn more about the diagnosis and treatment of twin-to-twin transfusion syndrome. En Español »
Follow-up care for TTTS
If you undergo fetal intervention, your care team will provide detailed postoperative care and instructions to ensure your recovery. We will schedule you for an ultrasound exam at our Center one week after your procedure to re-evaluate the health of your twins.
After taking that exam, we recommend consulting your local maternal-fetal medicine specialist for weekly ultrasound examinations for at least three weeks. Ultrasound exams will then be scheduled according to your doctor for the duration of your pregnancy.
Volumes & outcomes
When seeking the best hospital for TTTS treatment, we encourage you to ask about the treatment team’s volumes and outcomes. Our team at the Center for Fetal Diagnosis and Treatment cares for a high volume of monochorionic twin pregnancies each year. Since 1995, more than 4,745 complicated multiple gestation pregnancies have been referred to the Center for Fetal Diagnosis and Treatment, including 2,522 referrals for TTTS.
This experience helps to continuously expand our understanding of these complex pregnancies and our ability to differentiate between conditions such as TTTS, selective fetal growth restriction (SFGR), twin anemia polycythemia sequence (TAPS), and twin reversed arterial perfusion (TRAP) sequence.
Tour our Fetal Center. The Wood Center for Fetal Diagnosis and Treatment has cared for many families and will support you throughout your journey as well.
What to expectFrom the moment of referral through delivery and postnatal care, your family can expect a supportive experience when you come to us with a diagnosis of a birth defect.
Related specialties and programs
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment
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