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Chapter 31 - Twin-to-Twin Transfusion Syndrome: Placental and Fetal Pathogenesis

from Complications of Monochorionic Multiple Pregnancy: Twin-to-Twin Transfusion Syndrome

Published online by Cambridge University Press:  21 October 2019

By
Fiona L. Mackie ,
Enrico Lopriore  and
Mark D. Kilby
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
University of Birmingham
Anthony Johnson
Affiliation:
University of Texas Medical School at Houston
Dick Oepkes
Affiliation:
Leids Universitair Medisch Centrum
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Summary

Twin-to-twin transfusion syndrome (TTTS) is a complication unique to monochorionic (MC) twins and affects 10–15% of MC twins, including MC twin pairs in higher order multiple pregnancies. The disease has fascinated obstetric specialists since it was first described in 1875 [1], when it was recognized as a condition not amenable to treatment and with a very high perinatal loss rate. Since then, TTTS has provided many challenges, not only in terms of deciphering the underlying pathogenesis but also in attempting to alter the clinical course of a condition with a >90% perinatal loss rate untreated and very high (>50%) neurological morbidity in any surviving babies [2, 3]. Outcomes improve dramatically with treatment, which will be discussed in detail in Chapters 32, 33, and 35. However, even with treatment 12% of TTTS pregnancies will end with a double fetal loss, and only 62% with two survivors [4].

Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 344 - 352
Publisher: Cambridge University Press
Print publication year: 2020

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