Being an identical twin myself, when I came across this rare disorder, I was obviously very interested!
Twin-Twin Transfusion Syndrome (TTTS) is a rare disorder affecting the placenta in identical twin pregnancies. It affects only those twins who share a monochorionic placenta, meaning twinning four or more days after conception. The complication in the placenta results from a shared placenta containing blood vessels, which connect the umbilical chords and circulation of the twins. As a result, blood begins to flow unevenly with one fetal twin receiving too much blood (recipient) and one receiving too little (donor). The recipient twin may experience heart failure due to a continual strain on the heart. The donor twin may experience anemia, insufficient nutrition, and oxygen due to its inadequate blood supply.
This blood imbalance may occur at any time during pregnancy or during birth.
The Twin to Twin Transfusion Syndrome Foundation gives a list of questions you should ask about your twin babies when getting an ultrasound:
1.Is the placenta monochorionic?
2. Are the babies the same sex?
3. Can you see the dividing membrane?
4. Is the placenta anterior or posterior?
5. Do the cords have 3 vessels or 2?
6. Are the cords fully attached to the placenta?
These questions are vital to receiving care for the twins. Treatment centers are available. One treatment is to use laser treatment on the placenta. The first intrauterine laser surgery was performed in 1988 by Dr. Julian E. De Lia. Other doctors have since been offering this surgery.
As an identical twin, I wonder if my parents knew about these questions they should have asked during pregnancy. What about all those parents who do not even know about complications of identical twins? Me and my twin sister had many complications at birth. Luckily, they were not from TTTS but they were complications nonetheless. I hope treatments and prevention for TTTS will be furthered because the thought of my twin sister having medical complications from birth is devastating.