Twin to Twin Transfusion also known as Fetofetal Transfusion is a very serious and progressive condition. It is caused by intrauterine blood transfusion from one twin to another twin. It occurs in identical twins with a monochorionic placenta. As there are no clear barriers between the two fetuses, the identical monochorionic twins share the same placenta. This placenta contains abnormal blood vessels that circulate between the twins and may cause an imbalance between them. In simpler terms, one twin will receive more blood than the other and the weight of one of the baby will be less than 20% from the other twin. This imbalance will not provide the baby with necessary nutrients or to even survive. As for the other twin with more blood, he will face more pressure on the heart.
Mirror Syndrome-The Symptoms
Twin to Twin Transfusion can be found out if the pregnant woman is facing the maternal mirror syndrome. This is when your symptoms are the same of the recipient baby with high cardiovascular activity. These conditions are referred as the symptoms of a sick fetus. The mother may develop symptoms that are similar to pre-eclampsia. This includes severe vomiting, hypertension, excessive protein in the urine and severe swelling. Maternal Mirror Syndrome may be rare but, it is very serious. If you feel that you are going through these conditions than consult your doctor immediately. You might need medical assistance and may be admitted in the hospital to monitor the twins. Other common symptoms include weight-gain by the mother, abdominal pain, and rapid growth of the womb.
Diagnosis of Twin To Twin Transfusion
The Twin to Twin Transfusion Syndrome can only be diagnosed when it is checked upon at all times. When you are pregnant with twins, your doctor will keep a check on you through ultrasound and see if the twins share the same placenta. If they do, then you may be at a high risk for this condition and will need regular scans to be done. It is better to schedule regular appointments with the doctor and get the ultrasound done preferably weekly after 16 weeks through the end of the pregnancy to monitor Twin to Twin Transfusion. This should be done even though the symptoms decrease, as a precautionary measure. Twin to Twin Transfusion is diagnosed in an ultrasound by checking the amniotic fluid around the twin. If there is less of amniotic fluid it will result in a lack of oxygen and kidney failure of the baby. Similarly the baby with more amniotic fluid will have increased urine output to support the high level of blood pumping through his system. Prenatal testing can determine if there is a twin to twin transfusion. A high weight difference can also be a warning even though it is not a precise measure for it.
Prevention of Twin To Twin Transfusion
there is no way to prevent the twin to twin transfusion from occuring. Nothing
can cause this medical condition, or prevent it .It is not an inherited
condition. It may even occur when a mother is in labor.
Treatment The earlier the twin to twin transfusion is diagnosed, the better chances there are to take care of the situation. The treatment differs from patient to patient as it totally depends on the symptoms of the mother to determine how the case should be tackled around. Your goal is to carry the fetuses throughout your pregnancy journey as your doctor monitors it by ultra sound. Fetal MRIs and echocardiograms can be used to track the problems of the babies’ heart and brain. There may be complications in case of preterm labor. You are likely to remain on bed rest throughout your pregnancy. The doctor may provide you with nutritious supplements. Amniocentesis can be prescribed to reduce the excess fluids and improve the blood flow in the placenta. At the time of delivery, you may need to be hospitalized earlier. Your doctor may plan for a minimal laser procedure to help you in the process. You may also have a cesarean delivery if the risks of preterm delivery are low and the babies have matured.
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