eMedicine Specialties > Obstetrics and Gynecology > Obstetrical Complications
Twin-to-Twin Transfusion Syndrome: Treatment & Medication
Updated: Aug 24, 2007
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Treatment
Medical Care
The most common procedure to treat TTTS is reduction amniocentesis. This procedure involves draining the amniotic fluid from around the recipient twin. This procedure may improve circulation in the donor twin.
Fetoscopic laser photocoagulation of chorionic plate vessels is a highly specialized procedure performed in a few centers around the world.
Medical care of twins after birth is directed toward problems related to prematurity, anemia, polycythemia, and hydrops fetalis.
- Severely anemic donor twins may require packed RBC transfusions or partial exchange transfusions.
- Polycythemic recipient twins may require partial exchange transfusion to lower serum hematocrit levels.
- Newborns with hydrops fetalis may require mechanical ventilation, thoracocentesis, pericardiocentesis, and paracentesis.
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
Treatment & Medication: Twin-to-Twin Transfusion Syndrome