Twin transfusion syndrome: what is it?

What is Twin Transfusion Syndrome?

Twin transfusion syndrome can occur in twin pregnancies where both babies are supplied by the same placenta. In 15 to 20 percent of these cases, the twins’ blood vessels form a connection that allows blood to be pumped from one baby to the other. As long as the blood circulation is balanced, this is not a problem. It only becomes critical when the balance is missing and one twin is chronically undersupplied. The twin who donates blood but does not receive does not grow, rarely urinates, and has little amniotic fluid. In the worst case, he can die from a lack of blood and oxygen. The twin who receives blood but rarely donates is also at risk because the excess blood puts a strain on his heart and he may develop heart problems. In addition, the amount of amniotic fluid increasestriggers preterm labor .

Twin Transfusion Syndrome: Symptoms and Signs

A multiple pregnancy is considered a high-risk pregnancy and will be monitored particularly closely by your doctor. In the period between the 17th and 25th week of pregnancy, the ultrasound can be used to determine whether the syndrome exists and how serious it is. However, it’s good to keep a few symptoms in mind, especially if you know your twins are sharing a placenta:

• From the 16th week of pregnancy , your belly is growing unusually fast and feels tight and uncomfortable. This can indicate more amniotic fluid in a twin.
• The increased amniotic fluid causes the uterus to stretch and sit very high. You can then feel them between the navel and breastbone, often have phases of shortness of breath and severe back pain.
• Labor starts as early as the 20th week of pregnancy .
• You feel that your babies are no longer moving. The malnourished baby then does not have the strength to move. The oversupplied baby has so much amniotic fluid that you can no longer feel the movement.

Twin Transfusion Syndrome: Treatment Options

If twin transfusion syndrome was detected during your pregnancy, there are two treatment options.

• To prevent a premature birth, the uterus is punctured with a narrow needle and the excess amniotic fluid of one twin is punctured and suctioned out. The process sometimes has to be repeated several times until the twins are viable from the 28th week of pregnancy even after a premature birth.
• In a prenatal operation, the babies’ connected blood vessels can be severed. Through a small incision in the abdominal wall, the doctor inserts a narrow instrument into the larger twin’s amniotic sac. With the help of a laser device, he obliterates the connected blood vessel and then removes the excess amniotic fluid. The method requires a precise approach and is only carried out in special centers.