Twin-to-twin transfusion syndrome (TTTS)

Posted by e-Medical PPT Monday, October 18, 2010
Twin-to-twin transfusion syndrome (TTTS) is a complication of disproportionate blood supply, resulting in high morbidity and mortality. TTTS occurs in approximately 5.5–17.5% of all monochorionic pregnancies that is multiple pregnancies where two or more fetuses share a chorion and hence a single placenta. Severe TTTS has a 60–100% mortality rate.
As a result of sharing a single placenta, the blood supplies of monochorionic twin fetuses can become connected, so that they share blood circulation.Depending on the number, type and direction of the anastomoses, blood can be transferred disproportionately from one twin (the "donor") to the other (the "recipient"). The transfusion causes the donor twin to have decreased blood volume, retarding the donor's development and growth, and also decreased urinary output, leading to oligohydramnios. The blood volume of the recipient twin is increased, which can strain the fetus's heart and eventually lead to heart failure, and also higher than normal urinary output, which can lead polyhydramnios.

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