Management of Twin-Twin Transfusion Syndrome (TTTS) is one of the most challenging clinical problems concerning multiple gestations. Approximately 20 percent of all twin pregnancies are monochorionic, and the incidence of TTTS in monochorionic diamniotic gestations is approximately 5 to 15 percent. TTTS is a phenomenon almost exclusive to monochorionic pregnancies.
The natural history of severe TTTS is well established with mortality rates approaching 80 to 100 percent if left untreated, especially when it presents prior to 20 weeks gestation in which case it tends to be more severe and more rapidly progressive. This is particularly troublesome given that two structurally normal fetuses are involved.
Under the direction of Dr. Timothy Crombleholme, the Colorado Fetal Care Center provides evaluation and treatment of pregnancies complicated by TTTS based on his experience with over 800 cases of TTTS with survival of one or both fetuses in 96% of pregnancies and survival of both in 90% of pregnancies.