What is TTTS?

Twin to Twin Transfusion Syndrome, TTTS, is a serious complication of the placenta in identical twin/multiples pregnancies. It occurs when the blood vessels from each twin become interconnected in the placenta and the blood flow becomes unbalanced. One twin then receives too much blood and nutrients and the other does not get enough. Approximately 10-15% of shared placenta (Monochorionic-Diamniotic or Mono/Di and Monochorionic-Monoamniotic or Mo/Mo) pregnancies will face TTTS.  If left undiagnosed and untreated TTTS has a survival rate of +/- 10%. But when monitored and with appropriate medical intervention the survival rate can improve to 70% or better.

As soon as you have been advised of a twins/multiples pregnancy make sure that you and your doctor know how many placentas you have. All single placenta, multiples pregnancies (Mono/Di and Mo/Mo) are at risk for TTTS, TAPS, TRAP and SIUGR. The number of placentas can be verified through ultra sound. If you have a Mono/Di or Mo/Mo pregnancy make sure you are informed about all types of Twin to Twin Transfusion Syndrome, talk to your doctor about frequent ultra sound monitoring, ask about a referral to an MFM and follow a diet full of healthy proteins to support your pregnancy.

Please click HERE for more information on the recommended steps for appropriate monitoring of a shared placenta pregnancy and TTTS.

Please click HERE for the most up to date TAPS monitoring and diagnosing recommendations.

Please click HERE for more information on the diagnosis of Twin to Twin Transfusion Syndrome, staging of severity and possible treatments.

Please click HERE for some of the most up to date research studies on TTTS, TAPS, TRAP, and SIUGR as completed by US Fetus.

Please click HERE for easy and healthy ways to add calories and proteins to your diet to support the growth and development of your babies.  

Other types of Twin to Twin Transfusion Syndrome

  • Twin Anemia Polycythemia Sequence, TAPS, occurs when the red blood cells slowly become dangerously divided between the twins leaving one with too high of a count, polycythemic, and one too low, anemic. This form of TTTS also puts both twins at risk. It can only be monitored and/or diagnosed via ultrasound doplers. Please click HERE for more in depth information on TAPS. Please click HERE for a medical advocacy group for TAPS.
  • Twin Reversed Arterial Perfusion, TRAP, occurs in approximately 1% of monochorionic twins. With appropriate care one twin can still be carried to term and born healthy. Please click HERE for more information on TRAP.
  • TTTS has also been medically documented to affect multiple placenta (Dichorionic-Diamniotic or Di/Di) multiples pregnancies, though this is extremely rare.

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