Twin-to-Twin Transfusion syndrome occurs specifically in identical twins that share the same placenta. The twins share not only the same placenta but some of the same circulation which allows the transfusion of blood from one twin to the other. The donor twin becomes small and anemic, and the other twin becomes large and overloaded with blood. This is estimated to occur in 5-10% of identical twin pregnancies and can range from mild to severe. Symptoms to the mother may include rapidly, enlarging abdomen over 2-3 weeks, premature labor and premature rupture of membranes. This scary disease may be suspected if a pregnant woman carrying twins finds her abdomen enlarging rapidly or it may also be able to be detected by an ultrasound examination of the uterus. Before birth it is possible to seal off some or all of the blood vessels the twins share using a laser but this requires operating while the fetuses are still in the womb which could be very dangerous to the life of the two twins and mother. Treatment after birth may be critical because newborns with twin-to-twin transfusion syndrome may be seriously ill at birth and require treatment in a intensive care unit.
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