Twin to Twin Transfusion Syndrome

Results in a case where identical twin fetuses share a single placenta and the monochorionic twin fetal blood supply is  connected.

The twin fetuses then share blood circulation.

Although each fetus uses its own portion of the placenta, the connecting blood vessels within the placenta allow blood to pass from one twin to the other.

Depending on the number, type and direction of the interconnecting blood vessels ( circulatory anastomoses), blood can be transferred disproportionately from one twin (the “donor”) to the other (the “recipient”).

The transfusion causes the donor twin to have:

  • decreased blood volume
  • retarded  development
  • impaired growth
  • decreased urinary output
  • resulting in lower than normal level of amniotic fluid (becoming oligohydramnios).

The transfusion causes the recipient twin to have:

  • Increased blood volume
  • heart failure, as the increased circulatory volume strains the heart
  • higher than normal urinary output, which can lead to excess amniotic fluid (becoming polyhydramnios

Treatment and Management:

early detection 

fetoscopic laser ablation:

use of laser therapy to correct and severe interconnected placental blood supply between the fetuses.


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