What are the treatment options for twin-to-twin transfusion syndrome?
At the Colorado Fetal Care Center at Children's Hospital Colorado, our doctors are experts at identifying and treating twin-to-twin transfusion syndrome.
We understand that receiving a TTTS diagnosis during your pregnancy can feel life-changing, but you'll have an entire team taking care of you and your twins. Our state-of-the-art facilities, extensive experience treating this condition and innovative treatment options may help your children thrive, both during pregnancy and after birth.
Time is critical when it comes to treating TTTS. The earlier this condition is caught, the more easily it can be treated. Many treatment options can start within hours or days of diagnosis.
Twin-twin transfusion treatment options include:
In cases of TTTS where the recipient baby shows signs of heart dysfunction, such as cardiomyopathy or hydrops, we can use a high blood pressure medication called Nifedipine.
This is a non-invasive, interventional method meant to stabilize the disease while we wait for other therapeutic options. The Nifedipine spreads through the mother’s bloodstream, crossing through the placenta to help her babies’ hearts.
An amnioreduction is a procedure where a doctor removes the extra amniotic fluid in the amniotic sac using a small needle with ultrasound guidance. The doctor will remove fluid until a mother's fluid levels return to normal.
Our fetal surgeons perform an amnioreduction to help prevent preterm delivery and any other complications related to polyhydramnios (too much amniotic fluid). The potential benefits of this TTTS treatment option include:
- Decreasing a mother's abdominal pressure
- Slowing the progression of the disease
- Improving blood flow between the babies
- (In rare cases) halting or even reversing the TTTS
Laser TTTS surgery
In severe cases of TTTS, our fetal surgeons will recommend laser surgery. When this is the best treatment option, we will ordinarily perform this minimally invasive fetal intervention within 24 to 72 hours of your evaluation.
The laser TTTS surgery, called Selective Fetoscopic Laser Photocoagulation (SFLP), takes place in a dedicated operating room within the Colorado Fetal Care Center, so your preoperative care, surgery and postoperative care will all take place in one location. Most of our mothers have an epidural before the surgery is started to ensure a painless procedure. We have a dedicated fetal anesthesiologist who is by your side every step of the way.
To perform the laser procedure, we insert a small camera into the uterus, under ultrasound guidance. We use this camera to identify the abnormal blood vessel connections between the babies. Then, we use a small laser device to block the abnormal vessel connections and definitively stop the harmful blood flow between the babies.
We usually also perform an amnioreduction after the laser to remove any excess amniotic fluid.
Why choose the Colorado Fetal Care Center for TTTS diagnosis and treatment?
TTTS outcomes proof points
When coming to the Colorado Fetal Care Center for TTTS treatment, parents can expect an unparalleled level of quality, coordinated care. In fact, we are one of the nation's top care centers for the treatment of pregnancies complicated by TTTS.
Due to our 24/7 care model, our care and expertise is never out of reach. We're here to handle whatever need you or your baby may have, no matter the time. Our Center is always staffed with the pediatric, neonatal and maternal fetal experts you need to handle high-risk pregnancy and TTTS complications.
Not only do we offer some of the most innovative fetal therapies around, but we’re constantly advancing the field. Because TTTS is a complicated disease and its causes are not yet understood, we collect detailed information on every TTTS pregnancy and investigate the underlying causes. This helps improve the outcomes for our patients.
A continuum of care: comprehensive treatment for TTTS
We understand the stress and fear that can come from learning your babies have TTTS. This is why we have specialized maternal and fetal medicine experts for every aspect of you and your babies’ care.
Additionally, we're one of the few centers that brings together the full multidisciplinary care team from the very beginning, ensuring the most responsive and comprehensive care plan – before and after birth.
And with a Level IV NICU and world-class pediatric experts right here on the Anschutz Medical Campus, we're able to ensure a smooth transition between the various providers involved in your care and any specialists your babies may need.
A multidisciplinary team of TTTS experts dedicated to you and your babies
At the Colorado Fetal Care Center, you will meet the various team members who are all dedicated to you and your babies. Each person plays a unique role in coordinating your care, evaluating your pregnancy, diagnosising your babies' condition, counseling about treatment options and treating your family. We also help you feel like you're part of your own care team, so you're informed every step of the way.
During your appointment, you will meet nurse coordinators, medical assistants, fetal sonographers, fetal ultrasound specialists, anesthesiologists, fetal cardiologists and fetal surgeons, including pediatric surgeons and maternal fetal medicine specialists. Learn about your visit to our Center.
And when it comes to treatment and procedures, you will be treated by dedicated TTTS specialists, including fellowship trained fetal surgeons, who have trained specifically and extensively for these procedures. Our expertise in treating TTTS means the best chance at a positive outcome for you and your babies. Take a look at our most recent fetal surgery and TTTS outcomes.
But experience at the Colorado Fetal Care Center goes beyond the medicine – we have care coordinators, social workers and staff to ease the stress of a TTTS diagnosis.
We attend to you and your family's needs, emotional or otherwise, and provide a personalized approach to navigating the entire process, including scheduling. In addition, we help coordinate the travel and stay for each patient while they are here.