Twin-to-twin transfusion syndrome (TTTS)

J Perinat Med. 2011 Mar;39(2):107-12. doi: 10.1515/jpm.2010.147. Epub 2010 Dec 13.


Twin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic (MC) twin pregnancies, characterized by the development of unbalanced chronic blood transfer from one twin, defined as donor twin, to the other, defined as recipient, through placental anastomoses. If left untreated, TTTS is associated with very high perinatal mortality and morbidity rates, due to a combination of fetal and/or obstetric complications. The reported prevalence is 10-15% of all MC twins, or about 1 in 2000 pregnancies. This consensus document reviews available evidence and offers practical guidance to clinicians by providing recommendations on various aspects concerning diagnosis and management of TTTS.

Publication types

  • Practice Guideline

MeSH terms

  • Female
  • Fetofetal Transfusion* / diagnosis
  • Fetofetal Transfusion* / etiology
  • Fetofetal Transfusion* / physiopathology
  • Fetofetal Transfusion* / therapy
  • Fetoscopy
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Laser Coagulation
  • Placenta / abnormalities
  • Placenta / blood supply
  • Pregnancy
  • Twins, Monozygotic
  • Vascular Malformations / complications