Obstetrics and Prenatal Medicine

Specialist treatments    <    Obstetrics
Advanced obstetrics, including twin to twin transfusion syndrome and high risk births

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Twin to Twin Transfusion Syndrome (TTTS)

It is thought that TTTS develops in at least 15% of cases where identical twins share a single placenta, which amounts to about one in 2,700 preganancies
As the foetuses develop there is repeated transfusion of small quantities of blood, from one umbilical cord to the other, because of intercomnecting blood vessels.
Drainage of amniotic fluid (serial amnioreduction) may reduce the risk of premature delivery.  TTFS will only stop in approx. 20% of patients and whilst there is no change in the effect on the foetuses there is a risk of causing miscarriage.
This can be dangerous because one foetus receives too much blood and may die of heart failure, whilst the other may die from malnutrition.

Standard treatment for TTFS

Laser therapy for TTFS

Laser therapy adds an additional step before the amnioreduction is performed. This is the use of laser to laser to close the connection of blood vessels between the two foetuses.
This gives each twin a much higher chance of developing normally, but it requires special equipment and expertise.
This is not yet widely available, but MHL can introduce patients to a university hospital in Germany where laser therapy for TTFS can be performed.

High risk births

Whilst birth can be an unpredictable experience, some women are known to be at much higher than normal risk and need extra facilities to be available in case of need.
MHL can introduce patients to university hospitals in Germany or the USA, or to prestigious centres in the UK (London) where mothers at risk can be cared for at this difficult time.
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