Our Saving Grace is a UK non-profit organisation. Founded in 2013, by Laura & Ryan, it is in memory of our angel Grace and in honour of her surviving twin sister Isabella seperated at birth by Twin To Twin Transfusion Syndrome.
Twin To Twin Transfusion Syndrome (TTTS)
Twin To Twin Transfusion Syndrome is a condition that affects monochorionic twin pregnancies. It affects, documented, 15% - 20% of all monochorionic twin pregnancies but this is thought to be a lot higher. Monochorionic twin pregnancies share a single placenta and TTTS is the definition of a disco-ordinated blood supply between the two foetuses, usually referred to as the 'donor' twin and the 'recipient' twin which leads to serious implications. It can take place in various forms, the most common version, acute and most recently discovered, TAPS. Twin Anemia Polycythemia Sequence. TTTS is usually picked up during routine ultrasound appointments where there is a considerable discrepancy either in the amniotic fluid levels or the size and weight of the foetuses where one foetus is getting too many nutrients and the other foetus is mal nourished. This then leads to too much and too little urination between the donor and recipient twin so one twin is almost always swimming in a pool of amniotic fluid whereas the other is shrink wrapped (polyhydramnios). This can sometimes be felt by the mother making her uncomfortable with pressure on her cervix. It can in some cases be a cause of pre term delivery. Without intervention the mortality rate for twins suffering TTTS is as high as 60% - 100% for one or both foetuses, due to the failure of vital organs. If one twin dies the chances of there being a surviving twin are dramatically reduced and if one twin does survives there is a 40% chance of brain damage amongst problems with their hearts and kidneys.
Unfortunately there are little answers and no definitive cure for such a cruel disease. Dependent on when TTTS is detected during pregnancy treatment can be offered but it must be remembered this is not a guaranteed survival of one or both twins. Laser intervention is the preferred treatment with a higher success rate but there is also an option of a less invasive procedure of an amnioreduction if you meet criteria. Laser intervention is when the abnormal connections to the placenta are eliminated and an amnioreduction is a removal of excess fluid. The criteria for the laser intervention is anywhere between stages 1 and 4 of TTTS (stage 5 is when one twin has passed away) and the criteria for an amnioreduction is during the early stages. The procedure responds better dependent on artery positions detected by ultrasound. The success rates are anything between 61% -83% for laser intervention for one or both foetuses and 26% - 51% for amnioreduction. The only other advice is usually strict bed rest for the entirety of pregnancy with frequent ultrasounds (can be daily) and there is some suggestions in upping protein intake in your diet but no valid studies to back this theory up.
A monochorionic twin pregnancy is extremely high risk. When this pregnancy is confirmed by ultrasound there are very important guidelines that must be followed in order to detect early TTTS if it does strike. TTTS really does translate to knowledge is key. There are signs and symptoms the expectant mother should be aware of as swift intervention is imperative to increase the twin's chances of survival.
Just like monochorionic twin pregnancies, TTTS is a random occurrence. There is no evidence to say it is hereditary or genetic (monochorionic twin pregnancies are spontaneous events) and there is nothing that can be related back to what the parents may or may not have done.
Unfortunately there are little answers and no definitive cure for such a cruel disease. Dependent on when TTTS is detected during pregnancy treatment can be offered but it must be remembered this is not a guaranteed survival of one or both twins. Laser intervention is the preferred treatment with a higher success rate but there is also an option of a less invasive procedure of an amnioreduction if you meet criteria. Laser intervention is when the abnormal connections to the placenta are eliminated and an amnioreduction is a removal of excess fluid. The criteria for the laser intervention is anywhere between stages 1 and 4 of TTTS (stage 5 is when one twin has passed away) and the criteria for an amnioreduction is during the early stages. The procedure responds better dependent on artery positions detected by ultrasound. The success rates are anything between 61% -83% for laser intervention for one or both foetuses and 26% - 51% for amnioreduction. The only other advice is usually strict bed rest for the entirety of pregnancy with frequent ultrasounds (can be daily) and there is some suggestions in upping protein intake in your diet but no valid studies to back this theory up.
A monochorionic twin pregnancy is extremely high risk. When this pregnancy is confirmed by ultrasound there are very important guidelines that must be followed in order to detect early TTTS if it does strike. TTTS really does translate to knowledge is key. There are signs and symptoms the expectant mother should be aware of as swift intervention is imperative to increase the twin's chances of survival.
Just like monochorionic twin pregnancies, TTTS is a random occurrence. There is no evidence to say it is hereditary or genetic (monochorionic twin pregnancies are spontaneous events) and there is nothing that can be related back to what the parents may or may not have done.
