Presentation
In Chapter 2, an overview of the literature is presented. [openaccess.leidenuniv.nl]
[…] large study showed that Quintero stage at presentation, at first treatment and at worst stage did predict both prenatal and double survival but not survival of any twin Tan TYT, Taylor MJO, Lee LY et al. [quizlet.com]
The main problem in our series was that patients were referred too late, and thus presented with more severe complications. [scielo.br]
We also present highlights of the placental examination so the neonatologist can inspect the placenta at the time of delivery and possibly gain insights that may affect patient care. [neoreviews.aappublications.org]
Twin-twin transfusion syndrome poster presentation (click to enlarge) Twin-twin transfusion syndrome (TTTS) is a rare syndrome that only occurs in monochorionic (identical) twin pregnancies, where two fetuses share a single placenta. [womensandinfantshealth.ca]
Entire Body System
- Congestive Heart Failure
heart failure and polyhydramnios appear. [revistas.uis.edu.co]
Receiving excess blood places continual strain on the fetus’s heart and blood vessels (cardiovascular system), which may eventually cause congestive heart failure. [rarediseases.org]
- Soft Tissue Swelling
This may lead to heart failure, generalized soft tissue swelling, and in some cases, fetal death. The donor twin is at risk for failure of the kidneys and other organs because of inadequate blood flow. [ucsfbenioffchildrens.org]
The recipient twin, having to pump the thick extra volume of blood, can develop heart failure, generalized soft tissue swelling (“hydrops”), and, in some cases, fetal death. [fetus.ucsf.edu]
They also will monitor the twins for heart failure, soft tissue swelling, abnormal and/or differing fluid volumes and abnormal blood flow in the umbilical arteries. [chw.org]
Musculoskeletal
- Swelling of Hand
Warning signs in the mother include: A feeling of rapid growth of the uterus A large uterus Abdominal pain or tightness Premature contractions Sudden increase in weight Swelling of hands and feet in early pregnancy Warning signs on the ultrasound scans [lexology.com]
Other TTTS warning signs include: Rapid weight gain Sudden, dramatic increases in abdominal size Abdominal pain Decreased fetal movements Premature contractions Swelling in hands and feet Laser procedure saves lives Dr. [kansashealthsystem.com]
Fetus
- Placental Disorder
disorders O43.891 Other placental disorders, first trimester O43.892 Other placental disorders, second trimester O43.893 Other placental disorders, third trimester O43.899 Other placental disorders, unspecified trimester O43.9 Unspecified placental disorder [healthprovidersdata.com]
disorders Inclusion term(s): Placental dysfunction O43.891 Other placental disorders, first trimester O43.892 Other placental disorders, second trimester O43.893 Other placental disorders, third trimester O43.899 Other placental disorders, unspecified [icd10coded.com]
( O44.- ) placental polyp ( O90.89 ) placentitis ( O41.14- ) premature separation of placenta [abruptio placentae] ( O45.- ) Placental disorders O43.01 ICD-10-CM Diagnosis Code O43.01 Fetomaternal placental transfusion syndrome 2016 2017 2018 2019 Non-Billable [icd10data.com]
Parent Code: O43 - Placental disorders [icd.codes]
Psychiatrical
- Suggestibility
Our findings suggest that velamentous cord insertion and smaller placental share in donor twins are a consequence of developing TTTS, rather than a cause of TTTS. [openaccess.leidenuniv.nl]
Amnioreduction Often suggested for mild cases of TTTS, amnioreduction is an office procedure that removes excess amniotic fluid and improves blood flow to the fetuses. [carolinashealthcare.org]
According to the Twin to Twin Transfusion Syndrome Foundation, early research suggests links between maternal nutrition and TTTS. If you have a high-risk pregnancy, your doctor may recommend a specific diet, or prescribe vitamins. [healthline.com]
However, several disadvantages of using a narrower and shorter endoscope have been suggested, including lower image quality, which was not observed in our study, and limited assessment of the deepest fetal or placental structures. [scielo.br]
Urogenital
- Enlarged Uterus
Ultrasounds will be repeated frequently to monitor for signs of TTTS, including an enlarged uterus, fetuses of differing sizes and varying amniotic fluid levels in the amniotic sac. [chw.org]
Treatment
Laser treatment is a more permanent treatment for TTTS than drainage, which often has to be repeated. However, laser treatment is more complex and is only available at a few hospitals. Your doctor should discuss the possible risks of each procedure. [babycentre.co.uk]
In most cases, the optimal treatment is fetoscopic laser intervention. The UCSF Fetal Treatment Center was one of the first in the world to perform fetoscopic laser intervention to treat TTTS. [ucsfbenioffchildrens.org]
If that’s the case, the treatment will need to be performed again. Selective reduction. This would be the last option for treatment. [fetaltonewborn.org]
Not every pregnancy will require fetal treatment. The Ochsner team is here to help and support you and your family throughout this experience. [ochsner.org]
If TTTS occurs late in pregnancy it may not require any treatment, but in early occurrences treatment is essential to the survival of both fetuses. [embryo.asu.edu]
Prognosis
Prognosis The prognosis for twin-to-twin transfusion syndrome depends on the severity of the condition. If the TTTS is mild and the blood imbalance is not too great, both babies are likely to recover completely. [pregnancycorner.com]
This review analyzes the possible pathophysiological mechanisms involved, discusses the latest findings in diagnosis, therapy and prognosis, and focuses on neonatal and pediatric morbidity associated with TTTS. [ingentaconnect.com]
Because of the dismal prognosis of TTTS, various treatment methods have been advocated. [fetalhealthfoundation.org]
The timing of the disease ultimately determines the prognosis for the babies. It is easier to overcome later in pregnancy, when the simplest solution is to deliver the babies. [familyeducation.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Pathophysiology: The primary etiology of TTTS is thought to involve intertwin vascular connections within the placenta ( Figure 4 ). [smfm.org]
Fries MH, Goldstein RB, Kilpatrick SJ et al. (1993) The role of velamentous cord insertion in the etiology of twin-twin transfusion syndrome. Obstet Gynecol 81:569–574 PubMed Google Scholar 12. [link.springer.com]
This concise guide describes the etiology, diagnosis and treatment of TTTS. [twinstuff.com]
Mycobacterial Species Candida Infection SECTION III: VILLITIS ASSOCIATED WITH SPECIFIC INFECTIONS Cytomegalovirus Parvovirus B19 Herpes Simplex Virus Other Viruses Syphilis Coccidioidomycosis Parasitic Infections SECTION IV: CHRONIC VILLITIS OF UNKNOWN ETIOLOGY [euro-libris.ro]
Epidemiology
Epidemiology/Incidence: TTTS complicates about 8-10% of MCDA pregnancies. The prevalence of TTTS is approximately 1-3 per 10,000 births. [smfm.org]
Epidemiology Frequency United States Monozygotic twins occur in 3-5 per 1000 pregnancies. Monozygotic twins can be monochorionic or dichorionic. Approximately 75% of monozygotic twins are monochorionic. Only monochorionic twins are at risk for TTTS. [emedicine.medscape.com]
Epidemiology[edit] Based on recent (2005) US NCHS data, the rate of multiple births is now approximately 3.4% (4,138,349 total births, of which 139,816 were twins or higher-order multiple births). [en.wikipedia.org]
Malin G, Tonks A, Morris R et al (2012) Congenital lower urinary tract obstruction: a population-based epidemiological study. BJOG 119:1455–1464 CrossRef PubMed 22. [springermedizin.de]
Chorionicity and amniocity in multiple pregnancies affect the risks and therefore management of the pregnancy and so are assessed in early scans. [ 2 ] Epidemiology The incidence of twin pregnancy varies worldwide, from a low incidence of 6.7 per 1,000 [patient.info]
Pathophysiology
This review analyzes the possible pathophysiological mechanisms involved, discusses the latest findings in diagnosis, therapy and prognosis, and focuses on neonatal and pediatric morbidity associated with TTTS. [ingentaconnect.com]
Wieacker P, Wilhelm C, Prömpeler H et al. (1992) Pathophysiology of polyhydramnios in twin transfusion syndrome. Fetal Diag Ther 7:87–92 Google Scholar 32. [link.springer.com]
Pathophysiology: The primary etiology of TTTS is thought to involve intertwin vascular connections within the placenta ( Figure 4 ). [smfm.org]
Introduction: twin twin transfusion syndrome is one further complication in the 10-15% of all monochorionic-biamniotic pregnancies, it is known that part of its pathophysiology corresponds to the presence of placental anastomosis between two fetuses that [revistas.uis.edu.co]
Prevention
Many cases of TTTS can’t be prevented, but maintaining a healthy diet before and during pregnancy can help to prevent TTTS, or make it less severe if it does occur. Take prenatal supplements as recommended by your doctor. [healthline.com]
The recipient twin may also need to take medicine to prevent heart failure. If the twin-to-twin transfusion is mild, both babies often recover fully. Severe cases may result in the death of a twin. TTTS; Fetal transfusion syndrome Carlo WA. [medlineplus.gov]
Therefore in some instances, a failure to have identified a mono-chorionic (identical) pregnancy and/or to properly monitor and follow up for the development of TTTS, may result in a preventable birth injury should harm result to one or both of the twins [bila.ca]
Show More Because TTTS is a progressive disorder, early treatment may prevent complications such as preterm labor and premature rupture of membranes due to excessive amniotic fluid. [ucsfbenioffchildrens.org]