It is a complication seen in monochorionic twins, ie, where
twins have a single common placenta. Dichorionic, that is, it is not seen in
twin pregnancies with separate placenta. It is a condition caused by the blood
flow partnership that occurs between the common placenta of infants. The baby
with more blood flow is called the receiving baby, and the baby with less blood
flow is called the donor baby. It occurs in about 15 percent of monochorionic
twins. The risk of recurrence of Twin to Twin Transfusion Syndrome in
subsequent pregnancies is extremely low.
Diagnosis:
The appearance of the following conditions on ultrasound
creates suspicion that Twin to Twin Transfusion Syndrome has developed:
- More than 20% weight difference between fetuses
- Size difference between amniotic sacs
- Difference between cord thickness
- Placenta being single
- Finding signs of heart failure in the receiving baby
- Polyhydrasmios in the recipient fetus, oligohydramnios in
the donor fetus
- The genders are the same
- Urine bag is large in the receiving baby and small in the
donor baby
- Hydrops monitoring in one of the babies (fluid collection
in the heart and lungs, fluid in the abdominal cavity, skin edema)
In cases where severe oligohydramniosis is present, the donor
fetus is trapped on the edge, this is called stuck twin syndrome.
Twin to Twin Transfusion Syndrome is divided into stages
according to the Quintero staging system by making use of ultrasound and
doppler findings. According to this system:
- Stage 1: There is urine in the bladder of the donor twin.
- Stage 2: No urine is observed in the bladder of the donor
twin.
- Stage 3: There are abnormal doppler findings.
- Stage 4: One of the twins has hydrops.
- Stage 5: One or both of the twins are dead.
Treatment:
For treatment, the baby's fluid, which is amniotic fluid, can
be taken as needed during pregnancy, that is, amnioreduction procedure. The
process of tearing the amniotic membrane between the babies with a needle
(septostomy) is also a beneficial process by providing the baby with low water
to pass amniotic fluid. The blood flow between the babies is tried to be
prevented by applying laser to the vessels in connection with the placenta.
Given that they have completed the proper development that babies can live in,
delivery takes place.
Complications
of twin to twin transfusion syndrome:
- Early birth
- Respiratory, heart, kidney, brain and digestive system
problems in infants
- Anemia in the donor baby
- Death can be seen in infants
-WHAT SHOULD BE DONE TO HAVE TWIN PREGNANCY?
-IDENTICAL TWINS
-FRATERNAL TWINS
-TRIPLET PREGNANCY
-NORMAL BIRTH OR CESAREAN IN TWIN PREGNANCIES?
-TWIN TO TWIN TRANSFUSION SYNDROME
-CAN THERE BE TWIN BABIES FROM DIFFERENT FATHERS?
-CAN ANOTHER PREGNANCY OCCUR DURING PREGNANCY?
-VANISHING TWIN SYNDROME
-FETUS IN FETU (FIF)
-CHIMERISM
