I'm happy to share a guest post with you today, written by Kate Phillipa Clark, the founder of about-twins.com, a wonderful resource website for those expecting and parenting twins. In this artcile Kate talks about Twin to Twin Transfusion Syndrome, which can be a serious complication of having twins, who share a placenta. Whilst it's really improtant to educate yourself about this, I want to make clear that it is only a concern to you if your twins share a placenta, and even then it only affects about 8-10% of monochorionic pregnacnies (source), so there is no need to get unduly scared, just speak to your sonographer and doctor at your next appointment.
Women
pregnant with twins need to know their twins chorionicity. It’s extremely
important to know whether or not you expect twins who share a placenta to be on
the lookout for conditions like Twin to Twin Transfusion Syndrome (TTTS).
It might not be the first thing you think
about when you learn that you’re expecting twins. But knowing chorionicity in twins is extremely
important. Chorionicity relates to whether or not your twins share a placenta.
Twins who share a placenta are called monochorionic twins. A sonographer
determines chorionicity by using ultrasound at the dating scan during your first
trimester. If you learn that you are carrying monochorionic twins, you’ll need
to be monitored more often than with dichorionic twins. Dichorionic twins have
separate placentas and are not at risk of the same conditions as monochorionic
twins.
Complications
only related to monochorionic twins
There are several twin pregnancy complications that
are only associated with monochorionic twins due to the shared placenta. One of
those is Twin to Twin Transfusion Syndrome
(TTTS). The condition is caused by a complication of disproportionate blood
supply in the placenta. There are blood vessels within and on the surface of
the shared placenta connecting both twins. Usually, these vessels allow blood
to flow evenly between the babies, but, in rare cases, the blood flow becomes
unbalanced. The twins share blood circulation and the blood is transferred
disproportionately from one twin to the other.
Monochorionic
twins need to be referred to a MFM specialist
In mild TTTS cases you may be able to get by
with aggressive monitoring whereas other cases require treatment. There are several stages of TTTS. Severe,
progressive TTTS is associated with close to 100 percent mortality if left
untreated. The outlook for twins who get laser surgery for TTTS is much
better. It’s very important that your doctor is aware of the risks
associated with expecting monochorionic twins, and that he or she refers you to
a Maternal Fetal Medicine (MFM) specialist if there’s any reason for concern.
This should also be the case if your doctor isn’t able to detect your twins
chorionicity. Your MFM specialist will do a Doppler ultrasound to estimate
blood flow through blood vessels in the placenta and umbilical cords. This is
the best way to monitor whether or not you show signs of TTTS.
4 other
signs that might indicate a TTTS issue:
- Rapid growth of the womb and a uterus that
measures large for dates
- Abdominal pain, tightness and contractions
- Sudden increase in your body weight
- Swelling in the hands and legs
It’s important that you contact your midwife/doctor immediately if you experience signs that worry you. Severe TTTS can progress
really quickly and intervention is crucial in those cases.
Read about other mothers TTTS experiences and find out how
they coped with the condition.
Why not pin this post for later?
About the Author: Kate Phillipa Clark
Kate is a journalist writing about twins and
their parents on about-twins.com.
She’s written a great deal about twin pregnancy, twin pregnancy complications, twin birth and premature twins. Kate graduated
with a bachelor's degree in journalism and an Executive Master in Corporate
Communication. For some years, she worked in the private sector, before
launching About Twins in 2016. She’s an identical
twin and so is her father.
