What is the outcome for a fetus with Twin to Twin Transfusion Syndrome (TTTS)?
In Twin to Twin Transfusion Syndrome (TTTS) the donor twin responds by partially shutting down blood supply to many of its internal organs, especially the kidneys, has reduced urine output and therefore a small amniotic fluid volume (oligohydramnios) in its amniotic cavity. The recipient responds to the blood transfusion by producing excessive amounts of urine, and is surrounded by a large volume of amniotic fluid (polyhydramnios). It is the combination of oligohydramnios/polyhydramnios that suggests the diagnosis of TTTS. The twins are often discrepant in size, as well, with significant discordance in estimated fetal weights. The recipient’s blood becomes thick and difficult to pump around the body, and this can result in heart failure, generalized soft tissue swelling (hydrops) and fetal death. Because of the blood vessel connections across the placenta, if one twin dies, the co-twin faces significant risk for death or damage to vital organs. If a co-twin survives, there is a high ri
