Twin–Twin Transfusion Syndrome: A Population-Based Study

Abstract

Increased morbidity and mortality of twins with twin-twin transfusion syndrome is likely to be due to a higher incidence of preterm birth. Birth weight discordancy was not found to be an independent predictor of mortality after controlling for gestational age and twin-twin transfusion syndrome.

A Comparison of Twin Birthweight Data From Australia, the Netherlands, the United States, Japan, and South Korea: Are Genetic and Environmental Variations in Birthweight Similar in Caucasians and East Asians?

“…TTTS is a complication unique to monochorionic twins and is characterized by failure of balance in blood and nutritive sharing. The major features in TTTS are discordance of fetal birthweight, amniotic fluid volumes and fetal hemoglobin concentrations (Lutfi et al, 2004). Measurement errors, if they are uncorrelated within twin pairs, will be confounded in the estimate of nonshared environmental effects.…”

Twin-to-twin transfusion syndrome: an antiangiogenic state?

“…However, the presence of vascular anastomosis is necessary but not sufficient to induce TTTS. Indeed, almost all monochorionic twin placentas have vascular anastomoses; 16-18 however, TTTS is present only in 5 to 15% of these pregnancies, [19][20][21] and no more than 25% of the MC twin pairs with TTTS have >15% of hemoglobin discordance. 22 Thus, although placental vascular anastomoses are a sine qua non requirement for the development of TTTS, the pathophysiology of TTTS may not be explained only on the basis of placental vascular anastomoses.…”

Altered Fetal Cerebral and Cerebellar Development in Twin-Twin Transfusion Syndrome

“…In twins, TTTS is a significant cause of cerebral palsy (motor disability) and cognitive and behavioral disabilities 4,5 and is a major cause of prematurity. [6][7][8] There is a high risk of morbidity (12%-22%) 4,[9][10][11] and perinatal mortality (30%) in survivors even after treatment.…”