eMedicine Specialties > Obstetrics and Gynecology > Obstetrical Complications
Twin-to-Twin Transfusion Syndrome: Follow-up
Updated: Aug 24, 2007
Follow-up
Complications
- Neurologic sequelae
- Intrauterine demise of one twin can result in neurologic sequelae in the surviving twin.
- Acute exsanguination of the surviving twin into the relaxed circulation of the deceased twin can result in intrauterine CNS ischemia.
Prognosis
Outcome is dependent upon gestational age at birth and whether intrauterine fetal brain ischemia occurred. The lower the gestational age at birth the greater the risk for long-standing neurologic or pulmonary sequelae. Catch-up growth occurs postnatally in most of the smaller donor twins.
Miscellaneous
Medicolegal Pitfalls
Monochorionic twin pregnancies are considered high-risk situations and require very close obstetrical monitoring. Newborns with twin-to-twin transfusion syndrome (TTTS) may be critically ill at birth and require specialized care in neonatal intensive care units. These infants are at significant risk for neurologic sequelae.
More on Twin-to-Twin Transfusion Syndrome |
| Overview: Twin-to-Twin Transfusion Syndrome |
| Differential Diagnoses & Workup: Twin-to-Twin Transfusion Syndrome |
| Treatment & Medication: Twin-to-Twin Transfusion Syndrome |
Follow-up: Twin-to-Twin Transfusion Syndrome |
| Multimedia: Twin-to-Twin Transfusion Syndrome |
| References |
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References
Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M. Staging of twin-twin transfusion syndrome. J Perinatol. Dec 1999;19(8 Pt 1):550-5. [Medline].
Brackley KJ, Kilby MD. Twin-twin transfusion syndrome. Hosp Med. Jun 1999;60(6):419-24. [Medline].
Denbow ML, Battin MR, Cowan F, et al. Neonatal cranial ultrasonographic findings in preterm twins complicated bysevere fetofetal transfusion syndrome. Am J Obstet Gynecol. Mar 1998;178(3):479-83. [Medline].
Duncan KR. Twin-to-twin transfusion: update on management options and outcomes. Curr Opin Obstet Gynecol. Dec 2005;17(6):618-22. [Medline].
Elliot JP. Amniocentesis for twin-twin transfusion syndrome. Contemp Ob Gyn. 1992;37:30-47.
[Best Evidence] Fox C, Kilby MD, Khan KS. Contemporary treatments for twin-twin transfusion syndrome. Obstet Gynecol. Jun 2005;105(6):1469-77. [Medline].
Huber A, Diehl W, Bregenzer T, Hackelöer BJ, Hecher K. Stage-related outcome in twin-twin transfusion syndrome treated by fetoscopic laser coagulation. Obstet Gynecol. Aug 2006;108(2):333-7. [Medline].
Machin GA, Keith LG. Can twin-to-twin transfusion syndrome be explained, and how is it treated?. Clin Obstet Gynecol. Mar 1998;41(1):104-13. [Medline].
Milner R, Crombleholme TM. Troubles with twins: fetoscopic therapy. Semin Perinatol. Dec 1999;23(6):474-83. [Medline].
Sueters M, Middeldorp JM, Lopriore E, Oepkes D, Kanhai HH, Vandenbussche FP. Timely diagnosis of twin-to-twin transfusion syndrome in monochorionic twin pregnancies by biweekly sonography combined with patient instruction to report onset of symptoms. Ultrasound Obstet Gynecol. Oct 2006;28(5):659-64. [Medline].
Taylor MJ, Govender L, Jolly M, Wee L, Fisk NM. Validation of the Quintero staging system for twin-twin transfusion syndrome. Obstet Gynecol. Dec 2002;100(6):1257-65. [Medline].
Yamamoto M, Ville Y. Recent findings on laser treatment of twin-to-twin transfusion syndrome. Curr Opin Obstet Gynecol. Apr 2006;18(2):87-92. [Medline].
Further Reading
Keywords
twin-to-twin transfusion syndrome, TTTS, stuck twin syndrome, stuck twin phenomenon, feto-fetal transfusion syndrome, interfetal transfusion syndrome, polyhydramnios, oligohydramnios, hydrops fetalis, thoracocentesis, pericardiocentesis, paracentesis, placental vascular anastomoses, anemia, plethora, polycythemia, hypocalcemia, renal dysfunction, thrombocytopenia, hyperbilirubinemia, intraventricular hemorrhage, periventricular leukomalacia, myocardial dysfunction, myocardial hypertrophy, valvular insufficiency, pericardial effusion, abnormal renal echogenicity, hypoxic-ischemic cortical necrosis, ascites, pleural effusions, cardiomegaly
Follow-up: Twin-to-Twin Transfusion Syndrome