Diagnosis and Management of Twin-to-Twin Transfusion Syndrome (TTTS) By Dr. Kunda Shahane – Mayflower Fetal Medicine & High-Risk Pregnancy Centre, Nagpur
Twin pregnancies bring double the joy but may also carry unique challenges, especially when complications like Twin-to-Twin Transfusion Syndrome (TTTS) arise. At Mayflower Fetal Medicine & High-Risk Pregnancy Centre in Nagpur, Dr. Kunda Shahane provides advanced diagnosis and treatment options to ensure the health of both babies and the mother.
What is Twin-to-Twin Transfusion Syndrome (TTTS)?
TTTS is a rare but serious condition that occurs only in monochorionic twin pregnancies, where twins share a single placenta. An abnormal connection between their blood vessels causes an uneven blood flow, leading to one twin (the donor twin) giving away more blood than it receives, and the other twin (the recipient twin) receiving too much blood.
Causes and Risk Factors
- Shared Placenta: Monochorionic twins share one placenta, leading to vascular imbalances.
- Unequal Placental Sharing: Abnormal vessel connections can disrupt blood flow.
- Increased Amniotic Fluid Levels: Differences in blood volume affect fluid balance in each sac.
Signs and Symptoms
- Rapid Growth of Abdomen: Due to excess amniotic fluid in the recipient twin.
- Small Size of Donor Twin: Slower growth due to reduced nutrients and oxygen.
- Unequal Amniotic Fluid Levels: Polyhydramnios in the recipient twin and oligohydramnios in the donor twin.
- Fetal Distress: Reduced movements or irregular heartbeats.
- Maternal Discomfort: Premature contractions or pain due to excess fluid buildup.
Diagnosis of TTTS
Dr. Kunda Shahane uses advanced diagnostic tools, including:
- Ultrasound Imaging: Evaluates fetal growth, amniotic fluid levels, and blood flow.
- Doppler Studies: Measures blood flow patterns in the umbilical cord and fetal organs.
- Fetal Echocardiography: Assesses cardiac function in both twins.
- Sequential Monitoring: Tracks progression using standardized staging systems (Quintero stages).
Stages of TTTS (Quintero Classification)
- Stage I: Unequal amniotic fluid levels, but normal bladder size in the donor twin.
- Stage II: Donor twin’s bladder is not visible on ultrasound.
- Stage III: Abnormal blood flow detected in either twin.
- Stage IV: Signs of heart failure in the recipient twin.
- Stage V: Demise of one or both twins.
Management of TTTS
- Close Monitoring: Regular ultrasounds to assess changes in fluid levels and growth patterns.
- Amnioreduction: Draining excess amniotic fluid to relieve pressure and improve blood flow.
- Laser Ablation Therapy: A minimally invasive procedure that seals abnormal blood vessel connections, restoring balanced blood flow.
- Fetoscopic Laser Surgery: Performed with precision to treat vascular imbalances while preserving both twins.
- Selective Fetal Reduction: Considered in severe cases where one twin’s survival may compromise the other.
- Delivery Planning: Early delivery may be recommended if the condition progresses despite treatment.
Why Choose Mayflower Centre for TTTS Management?
- Expert Guidance by Dr. Kunda Shahane: Renowned specialist in fetal medicine and high-risk pregnancies.
- Advanced Imaging Technology: High-resolution ultrasound and Doppler systems for accurate diagnosis.
- Minimally Invasive Techniques: State-of-the-art laser therapies for safe and effective treatment.
- Multidisciplinary Approach: Collaborations with neonatologists and pediatric surgeons for postnatal care.
- Compassionate Support: Emotional counseling for parents during challenging times.
Outcomes and Prognosis
With early detection and timely intervention, the survival rates for twins affected by TTTS have significantly improved. The team at Mayflower Centre focuses on personalized care plans to optimize fetal outcomes and reduce complications.
Conclusion
Twin-to-Twin Transfusion Syndrome (TTTS) requires specialized care and expertise to ensure a positive outcome for both babies. At Mayflower Fetal Medicine & High-Risk Pregnancy Centre, Dr. Kunda Shahane combines advanced technology, experience, and compassionate care to manage high-risk pregnancies effectively.
For expert evaluation and treatment of TTTS, schedule a consultation with Dr. Kunda Shahane today!
Mayflower Centre – Delivering Hope and Health, Two Lives at a Time!
