Twin-to-Twin Transfusion Syndrome is a complication, which occurs due to an intrauterine blood transfusion from one twin to the other twin. It is also referred to as Feto-Fetal Transfusion Syndrome or FFTS. Twin-to-Twin Transfusion Syndrome is a rare condition, which occurs only in monozygotic (identical) twins having a monochorionic placenta. This condition occurs while the twins are still inside the mother’s womb. In cases of Twin-to-Twin Transfusion Syndrome, the donor twin is usually smaller than the recipient twin. The weight of the donor twin is around 20% less than the recipient twin at the time of birth. Also the donor twin is anemic and dehydrated.
In Twin-to-Twin Transfusion Syndrome the recipient twin is often born larger and are polycythemic, with increased blood pressure and excess blood volume. Based on the severity of the transfusion, both donor and recipient infants may face complications. In Twin-to-Twin Transfusion Syndrome, the donor twin may become hydropic due to anemia and high-output heart failure, while recipient twin may become hydropic as a result of hypervolemia. While the recipient twin will require a reduction in blood volume, the donor twin might require a blood transfusion. The prevalence of Twin-to-Twin Transfusion Syndrome is roughly one in a thousand pregnancies.
|
In many cases, the recipient twin after birth may also develop other complications like hypertrophic cardiomegaly, hypertension, disseminated intravascular coagulation and hyperbilirubinemia. Twin-to-Twin Transfusion Syndrome occurs only in 5-38% of monochorionic twins who make up roughly 75% of monozygotic twins. In many instances, premature delivery can result in a severe Twin-to-Twin Transfusion Syndrome whereby both fetuses may die, or cause serious disabilities. Approximately 60-100% neonatal mortality rate is the result of severe TTTS. Twins who are born premature are at a higher risk of postnatal mortality. Feto-Fetal Transfusion Syndrome occurs only in same sex, identical twins.
|
|
There are several therapies used in the treatment of Twin-to-Twin Transfusion Syndrome with varying rates of success. One of the most common procedures is through serial amniocentesis. This involves draining amniotic fluid periodically from around the recipient twin in an attempt to lessen the pressure of the amniotic fluid. Many doctors often advise complete bed-rest for the mother together with substantial intakes of protein as a therapy to try to offset the syndrome. There is another treatment procedure, which is done with the use of fetoscopy. This is known as Fetoscopic laser photocoagulation, which is a specialized procedure that is only performed in a few centers across the world.
For more updates on Obstetrical Complications, visit the related links provided on www.pregnancyxl.com
|
