Twin to twin transfusion syndrome is a serious complication that can occur in identical twin pregnancies. This condition causes an imbalance of blood flow in the twin fetuses, thus disrupting the supply of nutrients and oxygen they need.
Twin to twin transfusion syndrome occurs when the blood supply needed by the unborn fetus is unbalanced. As a result, one fetus gets an abundant supply of blood, while the other fetus is deficient.
Causes of Twin to Twin Transfusion Syndrome
The cause of twin to twin transfusion syndrome is not yet known with certainty. However, disruption of cell division after fertilization is claimed to be the cause of abnormalities of the placenta and blood vessels in TTTS.
TTTS is a condition that should not be underestimated. Imbalance of blood supply received by a twin fetus can interfere with its growth and development, even causing death.
A fetus that receives a small amount of blood can experience growth retardation and anemia. While other twin fetuses who get too much blood supply and experience excess fluid can experience disorders of the respiratory system, digestive system, heart, and brain.
Signs and Symptoms of Twin to Twin Transfusion Syndrome
Twin to twin transfusion syndrome is estimated to occur in 15 percent of identical twin pregnancies. Therefore, mothers who are pregnant with twins need to know the symptoms of this condition.
Here are the signs and symptoms of twin to twin transfusion syndrome that can be experienced by pregnant women:
- Rapid uterine growth.
- The size of the uterus and stomach is greater than gestational age in general.
- Increase in excess body weight.
- Abdominal pain, shortness of breath, and contractions.
- Swelling of the feet and hands early in pregnancy.
If you are pregnant with twins and find these signs or symptoms, consult your obstetrician immediately. The doctor will conduct a series of examinations, including ultrasound, to determine the cause of the complaint you are experiencing. If caused by TTTS, the ultrasound results will show the following:
- There is only one placenta.
- The size and weight of the two fetuses are different, even though they have the same sex.
- Difference in size of the amniotic sac and umbilical cord.
- Fluid buildup in one of the twin fetuses.
- Excess amniotic fluid in one twin fetus, while the other twin fetuses have a small amniotic fluid.
In addition to an ultrasound examination, the obstetrician may recommend other examinations, such as echocardiography, or MRI, to confirm the condition.
How to Overcome Twin to Twin Transfusion Syndrome
Pregnant women who are diagnosed with TTTS will be advised to regularly see a gynecologist. Treatment for TTTS depends on the severity. If TTTS is not severe, the doctor will monitor the condition of the fetus regularly. If the TTTS condition is suspected to inhibit and interfere with fetal growth and development, your doctor may recommend:
Amnioreduction
This action is done to reduce amniotic fluid in one fetus that has an excess supply of fluid. One of the most frequently used methods of aminoreduction is amniocentesis. This action aims to make the amount of amniotic fluid to normal and improve blood circulation to the fetus.
Laser fetoscopy surgery
If amnioreduction is not effective, then a laser fetoscopy procedure can be an alternative. This action is done by blocking the blood vessels that have abnormalities, so that the fetus can get a balanced blood supply.
Early or premature labor
In some cases, labor can also be an option to save the fetus. This action is usually recommended if the fetal lungs are mature.
Although including a rare condition, twin to twin transfusion syndrome should not be underestimated. This is because the condition of TTTS can adversely affect the fetus, ranging from stunted development, birth with a defect, to death. Therefore, it is important for pregnant women to check themselves regularly to the obstetrician.
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