Improving the odds for TTTS

When Jenna found out she was pregnant for the second time with twins, she and her husband were thrilled. But excitement turned to worry when they were told their identical twins boys had developed Twin to Twin Transfusion Syndrome (TTTS). One boy was given a 60 per cent chance of survival without intervention, the other a 10 per cent chance of even being born.

Photo of Jenna's family

Left to right: Clara, Jenna, Alex, Alasdair & Rory

TTTS is a disease of the placenta affecting twins. Abnormal blood vessels in the placenta allow the umbilical cords to connect, resulting in one twin taking blood and nutrients from the other. One twin suffers decreased blood flow and bladder activity, while the other twin’s heart is strained by the excess consumed.

Did you knowIn Canada, TTTS affects about 250 sets of twins each year, or about 15% of multiple pregnancies. When a family is given a TTTS diagnosis, they often rely on the Special Pregnancy Program at Mount Sinai Hospital, one of the only hospitals in Canada with expertise in this area. For more than 15 years, Dr. Greg Ryan, Head of Mount Sinai’s Fetal Medicine Unit, and his team have been performing in-utero laser surgeries that separate the umbilical cords, allowing the twins to develop properly.

“The keys to a positive outcome in TTTS are early diagnosis, prompt referral to a fetal therapy centre and appropriate management,” says Dr. Ryan. “Without treatment only 10 per cent of babies will survive, which improves to 85 per cent following corrective laser surgery.”

Jenna’s twins were diagnosed at stage three. One twin had almost no amniotic fluid and bladder function at 19 weeks and was measuring about two weeks behind his brother in growth. The other had dangerously high amounts of amniotic fluid. The family, who lives in Moncton, was told to book a flight to Toronto where surgeons at Mount Sinai were waiting for their arrival. 

The family arrived on a Wednesday and was assessed that afternoon. The following morning they were back for the procedure. Jenna and her husband watched on an overhead screen as the expert team separated the twins’ umbilical cords. Within 24 hours the twins showed improvement and the family was on their way home.

A few months later, Jenna and her husband welcomed Alasdair and Rory, who arrived kicking and screaming, but healthy and happy. The boys spent a few weeks at the hospital growing stronger before coming home.

Today the family is grateful for the care and expertise they received at Mount Sinai. Although there is no way to prevent TTTS, extra precautions such as early ultrasounds can make a difference for many babies. Jenna hopes other families will learn from their experience and that by sharing her story they can make a difference in the lives of others.

Jenna is the manager of momstown Moncton. You can read the original story here 


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Mount Sinai Hospital Foundation

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