TTTS Treatment Paola KS

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Angela Lea Piquard, MD
(913) 384-4990
401 S Clairborne Rd
Olathe, KS
Obstetrics & Gynecology
Medical School: St Louis Univ Sch Of Med, St Louis Mo 63104
Graduation Year: 1992

Data Provided By:
Miami County Surgical Assoc Llc
(913) 557-0700
2101 Baptiste Dr
Paola, KS
Brown David E
(913) 557-0700
2102 Baptiste Dr
Paola, KS
Paola Family Practice
(913) 294-2305
705 Baptiste Dr
Paola, KS
Alhosseini S Hamid Md
(913) 557-5678
2102 Baptiste Dr
Paola, KS
Petersen Kenneth Do
(913) 557-3800
2102 Baptiste Dr
Paola, KS
Powell Charles Lynne
(913) 557-2482
1604 Industrial Park Dr
Paola, KS
Banks Donald E
(913) 294-2305
705 Baptiste Dr
Paola, KS
Cardiology Services
(913) 294-2759
2102 Baptiste Dr
Paola, KS
Associates In Family Care
(913) 755-3044
100 E Main Osawatomie
Osawatomie, KS
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Twin-to-Twin Transfusion Syndrome (TTTS)

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Twin-to-Twin Transfusion Syndrome (TTTS) is a disease of the placenta. It affects pregnancies with monochorionic (shared placenta) multiples when blood passes disproportionately from one baby to the other through connecting blood vessels within their shared placenta. One baby, the recipient twin, gets too much blood overloading his or her cardiovascular system, and may die from heart failure. The other baby, the donor twin or stuck twin, does not get enough blood and may die from severe anemia. Left untreated, mortality rates near 100%.

Cause of Twin-to-Twin Transfusion Syndrome (TTTS)

The cause of TTTS is attributed to unbalanced flow of blood through vascular channels that connect the circulatory systems of each twin via the common placenta. The shunting of blood through the vascular communications leads to a net flow of blood from one twin (the donor) to the other twin (the recipient). The donor twin develops oligohydramnios (low amniotic fluid) and poor fetal growth, while the recipient twin develops polyhydramnios (excess amniotic fluid), heart failure, and hydrops. If left untreated, the pregnancy may be lost due to lack of blood getting to the smaller twin, fluid overload and heart failure in the larger twin, and/or preterm (early) labor leading to miscarriage of the entire pregnancy.

Some general treatment approaches consist of using laser energy to seal off the blood vessels that shunt blood between the fetuses. Because the surgical approach is via an operative fetoscope, there is minimal risk to the mother. Laser therapy for TTTS has been shown to provide improved pregnancy outcomes compared to alternative therapies. Although all treatment options should be discussed with your fetal surgeon.

Frequency of Twin-to-Twin Transfusion Syndrome (TTTS)

1 in 7 monochorionic pregnancies are afflicted with TTTS.

Diagnosis and Staging of Twin-to-Twin Transfusion Syndrome (TTTS)

The in utero diagnosis of TTTS is established by ultrasound. First, the presence of a shared placenta (monochorionic) confirmed. Ultrasounds performed earlier in the pregnancy may be useful in establishing the chorionicity (number of placentas). Ultrasound findings such as a single placenta, same fetal sex, and a "T-sign" in which the dividing membrane inserts perpendicular to the placenta are helpful in diagnosing a monochorionic twin gestation.

TTTS is then diagnosed simply by assessing the discordance of amniotic fluid volume on either side of the dividing fetal membranes. The maximum vertical pocket (MVP) of amniotic fluid volume must be greater than or equal to 8.0 centimeters in the recipient's sac, and less than or equal to 2.0 centimeters in the donor's sac.

Although TTTS is diagnosed via ultrasound, women with a monochorionic or monoamniotic pregnancy can be alerted to certain symptoms that may require medical attention. Symptoms may include a sudden ...

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