Twin-To-Twin Transfusion Syndrome

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  • Twin-To-Twin Transfusion Syndrome (TTTS)
    • What?
      • When twins share a placenta, and there is abnormal connecting blood vessels within it.
      • Results in a higher blood volume in one twin than the other.
      • This means that blood from one twin (donor) is transfused to the other (recipient).
      • The recipient twin has too much blood, so the heart has to work extra hard. The donor twin has too little blood, so may suffer from anaemia.
      • The donor twin may have a smaller amniotic sac, whilst the recipient may have a larger amniotic sac.
    • Who?
      • It effects twins who share a placenta.
      • It effects 10-15% of monochorionic (sharing a placenta and outer membrane) pregnancies.
    • Why?
      • Want to study midwifery at university.
      • Effects a significant number of pregnancies.
      • Interested in problems that can occur in multiple pregnancies
    • How?
      • Diagnosis
        • From as early as 12-14 weeks.
        • Detected through ultrasound scans.
        • Tell-tale signs include different sized babies, bladders or amniotic sacs.
      • Treatment
        • Amnioreduction
          • Draining of excess amniotic fluid from the recipient twin.
          • 44% success rate of having two babies 66% of producing one.
        • Septostomy
          • Creating a hole in the amniotic membrane between the babies, to allow the fluid levels to equalise.
        • Laser Treatment
          • Breaks the vessels causing the problem in the placenta.
          • Only treatment that can effectively reverse the effects of TTTS.
        • Selective Feticide
          • The termination of one foetus so that the other may survive.


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