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TTTT with identical twins - is there always a risk?

4 replies

Tiddybaps158 · 11/11/2011 22:51

Hi all, i've just joined here tonight (thanks to my sister!)

I'm 19 weeks pregnant with identical twins and I'm 42 so am told I'm high risk of twin to twin blood transfusion.

I don't know anyone else who has had identical twins, and was wondering does this always happen with identical twins sharing one placenta - and is there a chance it may not happen?

OP posts:
Are your children’s vaccines up to date?
GibberingGinger · 12/11/2011 21:41

Sorry I have no personal experience of identical twins, or TTTS. I've just posted on your sisters post with a link to some ladies who have experienced TTTS. I think the condition is quite rare, but hopefully Hopefully someone who has identical twins can come along and confirm that. Multiple births is not really a very active part of the forum (we all have our hands full!) but we are a friendly bunch when we do have the time to post!
Congratulations on your pregnancy.

AliceLost · 12/11/2011 21:42

I have no answers for you I'm afraid but just wanted to say welcome to MN, congratulations and good luck with your twins.

thingamajig · 12/11/2011 21:57

Hi, I have identical twins. I wasn't aware that the risks of TTTS increased with increasing maternal age, but either way, you will be closely monitored. I would imagine that you are already having fortnightly scans, which will be even more frequent if they are worried. TTTS certainly does not always happen, my girls were not affected at all, and if it does, things can be done. If I remember correctly, the most serious cases have started by 18 weeks, and if it is identified after about 26 weeks, they deliver the babies early. I assume your babies are MCDA, not mono-mono, which is the REALLY worrying sort of twins?
Anyway, the best person to talk about this to is your consultant, I am surprised that he/she has left you in this much doubt. Also, TAMBA are really helpful in their information about this sort of thing, I strongly recommend that you join them too, its only £2 something a month, and their discounts are good. Here is some info for you from them.

More than six per cent of mothers who responded to Tamba?s 2008 survey said their babies were affected by Twin to Twin Transfusion Syndrome (TTTS). While the condition is rare, Tamba wants to do more to help families whose twins were affected by it.

TTTS affects twins who share not only a placenta but also some of the same circulation, resulting in the transfusion of blood from one twin (the donor) to the other (the recipient) in the womb. In most cases the donor twin may become smaller and anaemic due to not having enough blood supply. The recipient twin has a higher blood volume, which can strain the foetus?s heart and lead to heart failure.

The donor twin is also likely to have a decreased urinary output, leading to a lower than normal level of amniotic fluid, whereas the reverse is true for the recipient twin. The excess fluid in the recipient twin (polyhydramnios) can be quite uncomfortable for the pregnant mother and pressure on the cervix can lead to ruptured membranes and early delivery.

During your first ultrasound scan, the sonographer will look to see if your twins are monochorionic (one chorionic membrane) and, if so, your pregnancy will be closely monitored for signs of TTTS. Indications of TTTS include differences in the size of the twins? abdomens, estimated birth weights, amounts of amniotic fluid and bladder volumes.

If diagnosed, health professionals will continue to monitor your pregnancy carefully with frequent ultrasound examinations. You may be referred to a specialist centre for laser ablation therapy, which separates the blood vessels in the placenta.
Royal College of Obstetricians and Gynaocologists Recommendation

"Women with monochorionic twin pregnancies should be asked to report sudden increases in abdominal size or breathlessness, as this may be a manifestation of TTTS."

Anyway, I wish you lots of luck with your pregnancy, feel free to join the "life with twins" threads

twinnies26 · 14/11/2011 14:10

Hi there -

First congratultions! :)

My ID twin girls are 6weeks old, they are TTTS babies and we had laser surgery at 17 weeks. If i remember correctly approx 10% of ID pregnancies get TTTS to some degree.

I presume you will be scanned every two weeks now? To make sure the condition doesn't develop.If there are any warning signs you will probably be scanned every week.

The only signs of the condition is a sudden swelling of your bump ( i didn't even notice,being first pregnancy i just thought i had got bigger suddenly). The condition does not affect the mother in any way, so there is not much you can do to prevent it happening, just be aware of the few symptoms that exist and make sure you are monitored regularily by your health provider.

DT1 kicking up a fuss must run!

Good luck

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