Twin-to-Twin Transfusion Syndrome (TTTS) is, fortunately, a very rare condition because it is also an incredibly serious one. Ensuring that babies who suffer from TTTS receive proper care is vital. When left untreated, the mortality rate for twins affected by this condition is a staggering 80 to 90 percent. In any pregnancy, it is important to get regular checkups and follow your doctor's advice. When giving birth to twins, that importance more than doubles.

Beyond TTTS, there are several other possible complications for a pregnancy involving twins. While you are giving birth to double the babies of a standard pregnancy, the risks are exponentially higher. Make sure to talk to your doctor about the possibility of this condition and other ways in which your pregnancy will be different from a single birth pregnancy.

What Is TTTS?

TTTS is a disease of the placenta. The syndrome can occur in cases where the twins share the same placenta, and abnormal blood vessels are present within the placenta. The presence of the abnormal blood vessels causes the twins to receive an unequal distribution of blood, with one twin getting too much and the other, not enough.

The twin receiving too much blood flow faces the potential dangers of high blood pressure and heart failure. On the other hand, the twin who doesn't get enough blood will likely be dealing with dehydration and developmental delays. With both twins facing serious conditions, they are both at high risk for death without treatment.

What Causes TTTS?

Unfortunately, there is no real known cause for TTTS. While the condition occurs only in cases where a placenta is shared between the twins, aside from that, there are no known risk factors. An occurrence is simply a random event, and nothing can be done to prevent it from happening.

TTTS is quite rare. The condition only happens in identical twins, as fraternal twins always have individual placentas. Identical twins only occur in three to four out of every one thousand births and make up about one-third of all twins. Around 70% of identical twins share a placenta, and only about 10% of those twins end up with TTTS.

That means that the dangers of TTTS occurring in a pregnancy overall are approximately 0.025%. Among twins, the odds of TTTS developing are around 2.3%, and the odds within identical twins sit at about seven percent.

A Deadly Condition

While TTTS is rare, it is still a deadly condition, not to be taken lightly. With such a high mortality rate for babies suffering from this syndrome, it is essential to be screened early. Like with all treatable medical problems, early detection and treatment often make all the difference.

In any pregnancy where identical twins are sharing a placenta, it is important to get properly checked for TTTS. One of the best ways to detect this syndrome is through a special type of ultrasound called a nuchal translucency ultrasound. The first ultrasound should be at 11 to 14 weeks, with additional ultrasounds performed every two weeks.

When TTTS is detected, treatment is necessary in order to protect the lives of the twins. One of the best treatments available for this condition is ablation. This treatment involves lasers which are used to cut and seal the blood vessel connections between the two babies. This operation separates the blood flow of the two babies, making it so that they receive their blood from the placenta independently and evenly.

When TTTS is detected early, and the syndrome is treated with laser ablation, the chance of both babies surviving rises to around 65%. Meanwhile, the odds of at least one baby making it through increases to 85%.

Stay Informed

The most important things you can do to protect yourself in pregnancy are to stay informed about everything that is going on inside your body and make sure that you have a doctor with whom you feel comfortable. A qualified doctor should actively ensure that you know how your pregnancy is progressing. 

A doctor who tells you that you are having twins, without further explanation about the type of twins and what additional complications this could create for your pregnancy, is not likely to be a doctor you want monitoring your pregnancy and delivering your baby. 

If you lost your pregnancy due to TTTS and you feel like your doctor did not suitably screen for this syndrome or treat it properly, you may have a case for legal action. Contact a twin-to-twin transfusion syndrome lawyer to talk about your options and whether your doctor was negligent in their duty to protect you and your pregnancy.