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Twin-to-Twin
Transfusion Syndrome

When Two or More Babies
Share a Placenta

By Alexandria Powell

In addition, if TTTS occurs after the point when the babies would be viable outside the womb (around 25 to 28 weeks gestation), it is often safer to focus on therapeutic measures and early delivery, Dr. Luks says.

Other factors that can affect treatment include cervical length, placental location and prior amnioreductions, says Dr. Ruben Quintero, professor and director of the Division of Maternal-Fetal Medicine at the University of South Florida College of Medicine. Triplets can also make surgery more difficult.

"The single most important message is that TTTS can be treated effectively today," says Dr. Quintero, who was the developer of the TTTS staging system. "Our current numbers show at least one fetus surviving in approximately 90 percent of patients, and two surviving fetuses in approximately 75 percent of patients. Although there can still be important complications, particularly resulting from prematurity, the overall prognosis for patients treated with the selective laser technique developed by us is extremely good."

After a diagnosis of TTTS, one of the first issues families struggle with is hope, says Lonnie Sommers, president, executive director and founder of the Fetal Hope Foundation. "There's a lack of information and awareness out there even in the medical community," Sommers says, with even many health care providers unaware of the tremendous advances made in TTTS care over the past 15 years.

Sommers speaks from personal experience. In 2003, he and his wife were expecting identical twins. During what they thought would be a routine ultrasound at 20 weeks, they found out that their babies were girls – and that they were suffering from severe TTTS. The Sommers were told that the babies would likely live only a few more weeks, and that while they could try to save them, the best option might be to terminate the pregnancy.

Want to see more?

• Vanishing Twin Syndrome: A Mysterious Occurrence in Multiple Pregnancies
• Check out our Article Library.
• Two Babies, One Sac, More Risks: The Triumphs of Monoamniotic Twins
• Double the Stuff? What You Really Need to Prepare for Twins
• Talk about it!

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