Can TTTS stay at Stage 1?

The overall survival was 79%, 77%, 68%, and 84% in stage 1 TTTS managed expectantly, by amnioreduction, laser surgery if there is progression, and laser as first-line treatment, respectively. The optimal initial management of stage 1 TTTS remains in equipoise.

How fast does TTTS progress?

Results: Among 132 consecutive cases of TTTS, 46 women presented with Stage I disease. In the majority (69.6%), disease remained stable (28.3%) or regressed (41.3%). Of cases that progressed, 79% did so within 2 weeks and 93% progressed to at least Stage III.

What happens during twin to twin transfusion?

The donor twin experiences progressive loss of blood volume (hypovolemia). Therefore, its kidneys don’t have to filter as much fluid from the blood, and as a result, urination decreases. This affects development of the bladder and leads to low levels of amniotic fluid.

What are the stages of TTTS?

Quintero TTTS Staging System

• Stage I: The fetal bladder of the donor twin remains visible on ultrasound.
• Stage II: The bladder of the donor twin is not visible on ultrasound.
• Stage III: Doppler studies in either twin are critically abnormal fetal.
• Stage IV: Fetal hydrops is noted.
• Stage V: Demise of one or both twins.

Can twins survive TTTS?

The majority of TTTS twins who have appropriate treatment during pregnancy will survive and the majority of survivors will be normal and healthy. If untreated, the survival rate for TTTS twins is approximately 10 to 15 percent.

Can TTTS go away?

If not treated, TTTS will continue to worsen and both babies will likely pass away (80-100% of the time). Babies that survive a pregnancy with severe TTTS and no treatment have a 1 in 4 risk of brain injury due to lack of oxygen, blood and other nutrients.

How rare is TTTS?

Twin to twin transfusion syndrome (TTTS) is a rare complication of pregnancy that develops in 10-15% of twins when the babies share the same placenta (monochorionic).

What are the stages of twin twin transfusion syndrome?

In TTTS, there is a characteristic series of pregnancy changes that happens due to the extra blood coming from the donor twin to the recipient twin. Stage 1: Polyhydramnios (too much amniotic fluid) in the recipient sac, oligohydramnios (little or no amniotic fluid) in the donor sac Stage 3: Abnormal blood flow patterns, including:

How does unequal blood flow between twins cause TTTS?

In TTTS, unequal blood flow between twins sharing a placenta results in recipient twin (right) having too much amniotic fluid, and donor twin with no surrounding amniotic fluid. In twin-twin transfusion syndrome, there is an unequal sharing of blood that passes between twins through blood vessel connections in the placenta.

How does Johns Hopkins treat twin to twin transfusion syndrome?

This surgery, known as endoscopic laser ablation, is performed in utero and can correct the blood-sharing imbalance caused by TTTS. This surgical video footage is presented by Dr. Ahmet Baschat, director of the Johns Hopkins Center for Fetal Therapy. The donor twin experiences progressive loss of blood volume ( hypovolemia ).

Where can I get help for twin to twin transfusion syndrome?

Twin to twin transfusion syndrome treatment is available at Midwest Fetal Care Center. In some TTTS cases only red blood cells transfer between the babies. In these cases the amniotic fluid levels remain normal.