Twin to Twin Transfusion Syndrome (TTTS)

With twins you get twice the love. But a multiple pregnancy might mean complications.

A condition called Twin to Twin Transfusion Syndrome (TTTS) occurs in about 15% of identical twins with a shared placenta. An imbalance in the blood vessels causes one baby (the donor) to receive too much volume from the placenta while the other baby (the recipient) doesn’t receive enough.

TTTS symptoms can come to light suddenly, and decisions about treatment must be made quickly. If and when you need TTTS experts you can trust, the leading team in the Gulf South is right here at Ochsner Baptist.

A shared placenta, as seen in identical twins, has numerous blood vessels. An imbalance in the blood vessel flow causes one baby (the donor) to receive too much fluid (or volume) from the placenta while the other baby (the recipient) doesn’t receive enough. With TTTS, the donor twin eventually has too little volume, while the recipient twin has too much volume. Once this happens the donor will stop making amniotic fluid (called oligohydramnios), while the recipient makes too much amniotic fluid (called polyhydramnios). If left untreated the donor will stop giving volume to its critical organs while the recipient will give too much to its organs. In both cases the babies can get very sick and sometimes die if not treated in time.

The good news is with early detection and treatment, babies with TTTS now have a 70 – 90% chance of survival.

To schedule an appointment or to tour the Ochsner Baptist NICU, call 504-842-3907.

When you first come to Ochsner for treatment, you will be scheduled for a full evaluation. Tests may include a high-resolution ultrasound and a fetal echocardiogram, which we have available on site for your convenience.

Our Fetal Therapy Team, comprised of maternal fetal medicine specialists, pediatric cardiologists, obstetrical anesthesiologists and neonatal intensive care providers, will discuss your test results and specific treatment options with you and your family in detail on the same day of your evaluation, including whether or not fetal intervention is recommended.

TTTS may be treated in any of the following ways:

Expectant management – Here your pregnancy would be followed with a series of ultrasound examinations.
Early delivery – Complications from TTTS may result in a recommendation to deliver your baby prematurely. Ochsner’s Level III NICU will be here if and when you need it.
Fetoscopic selective laser ablation – Fetal laser surgery to interrupt the abnormal vessels that allow exchange of blood between fetuses.
Serial amnioreduction – The repeated removal of excess amniotic fluid by amniocentesis.
Selective cord occlusion – The ligation of the umbilical cord to interrupt the exchange of blood between the fetuses. This is rarely offered and is considered a last resort for the most severe cases of TTTS.

Ochsner Baptist is home to a level III Neonatal Intensive Care Unit (NICU), the highest level designation awarded by the state of Louisiana. With three dedicated Care by Parent rooms, our families have the opportunity to spend some valuable time with their babies as they prepare for discharge. Webcam services allow families to have a continuous, secure view of their babies in the NICU that facilitates the bonding experience.

Not every pregnancy will require fetal treatment. The Ochsner team is here to help and support you and your family throughout this experience.

Learn More about the NICU at Ochsner Baptist

When Paige and Paul Prechter’s twins needed laser ablation surgery, they had to emergently travel to Texas for care. To make sure families in the future would be able to get that same life-saving fetal surgery right here at Ochsner, the couple established the Prechter Family Fund. Along with underwriting invaluable training for our team, the fund continues to improve our fetal care program in many ways including continuing education and patient assistance.

To learn how you can contribute to the Prechter Family Fund to help families in need, call 504-894-2017.