U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Twin-to-twin transfusion

MedGen UID:
777055
•Concept ID:
C2909036
•
Pathologic Function
Synonyms: Fetal transfusion syndrome; Fetofetal transfusion syndrome; Twin twin transfusion syndrome; Twin-to-twin transfusion syndrome
SNOMED CT: FFTS - Fetofetal transfusion syndrome (13404009); TTTS - Twin to twin transfusion syndrome (13404009); Fetofetal transfusion (13404009); Fetofetal transfusion syndrome (13404009); Twin-to-twin blood transfer (13404009)
 
HPO: HP:0031110
Monarch Initiative: MONDO:0019805
Orphanet: ORPHA95431

Definition

As a result of sharing a single placenta, the blood supplies of monochorionic twin fetuses can become connected, so that they share blood circulation [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVTwin-to-twin transfusion

Professional guidelines

PubMed

Comparison of international guidelines on the management of twin pregnancy.
Oliver E, Navaratnam K, Gent J, Khalil A, Sharp A
Eur J Obstet Gynecol Reprod Biol 2023 Jun;285:97-104. Epub 2023 Apr 7 doi: 10.1016/j.ejogrb.2023.04.002. PMID: 37087836
Twin-to-twin transfusion syndrome: Controversies in the diagnosis and management.
Bamberg C, Hecher K
Best Pract Res Clin Obstet Gynaecol 2022 Nov;84:143-154. Epub 2022 Mar 30 doi: 10.1016/j.bpobgyn.2022.03.013. PMID: 35589537
Screening, Management and Delivery in Twin Pregnancy.
von Kaisenberg C, Klaritsch P, Ochsenbein-Kölble N, Hodel ME, Nothacker M, Hecher K
Ultraschall Med 2021 Aug;42(4):367-378. Epub 2020 Oct 5 doi: 10.1055/a-1248-8896. PMID: 33017845

Recent clinical studies

Etiology

Early prediction of twin-to-twin transfusion syndrome: systematic review and meta-analysis.
Stagnati V, Zanardini C, Fichera A, Pagani G, Quintero RA, Bellocco R, Prefumo F
Ultrasound Obstet Gynecol 2017 May;49(5):573-582. doi: 10.1002/uog.15989. PMID: 27270878
Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis.
Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, Asztalos E, Hack K, Lewi L, Lim A, Liem S, Norman JE, Morrison J, Combs CA, Garite TJ, Maurel K, Serra V, Perales A, Rode L, Worda K, Nassar A, Aboulghar M, Rouse D, Thom E, Breathnach F, Nakayama S, Russo FM, Robinson JN, Dodd JM, Newman RB, Bhattacharya S, Tang S, Mol BW, Zamora J, Thilaganathan B, Thangaratinam S; Global Obstetrics Network (GONet) Collaboration
BMJ 2016 Sep 6;354:i4353. doi: 10.1136/bmj.i4353. PMID: 27599496Free PMC Article
Twin-twin transfusion and laser therapy.
Behrendt N, Galan HL
Curr Opin Obstet Gynecol 2016 Apr;28(2):79-85. doi: 10.1097/GCO.0000000000000247. PMID: 26871537
Examination of the twin placenta.
Paepe ME
Semin Perinatol 2015 Feb;39(1):27-35. Epub 2014 Nov 15 doi: 10.1053/j.semperi.2014.10.005. PMID: 25455620
Twin-to-twin transfusion syndrome.
Russell N, McAuliffe F, Carroll S, Mc Parland P
Ir Med J 2007 Jul-Aug;100(7):517-8. PMID: 17886522

Diagnosis

Ultrasonographic Diagnosis of Twin-to-Twin Transfusion Syndrome.
Reyna-Villasmil E, Briceño-Pérez C, Briceño-Sanabria JC
Am J Perinatol 2024 Apr;41(5):531-538. Epub 2022 Mar 9 doi: 10.1055/s-0042-1744259. PMID: 35263768
Twin-to-twin transfusion syndrome: Controversies in the diagnosis and management.
Bamberg C, Hecher K
Best Pract Res Clin Obstet Gynaecol 2022 Nov;84:143-154. Epub 2022 Mar 30 doi: 10.1016/j.bpobgyn.2022.03.013. PMID: 35589537
Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders.
Rana S, Burke SD, Karumanchi SA
Am J Obstet Gynecol 2022 Feb;226(2S):S1019-S1034. Epub 2020 Oct 20 doi: 10.1016/j.ajog.2020.10.022. PMID: 33096092Free PMC Article
Update on twin-to-twin transfusion syndrome.
Bamberg C, Hecher K
Best Pract Res Clin Obstet Gynaecol 2019 Jul;58:55-65. Epub 2019 Jan 5 doi: 10.1016/j.bpobgyn.2018.12.011. PMID: 30850326
Twin-to-twin transfusion syndrome: prenatal diagnosis and treatment.
Benoit RM, Baschat AA
Am J Perinatol 2014 Aug;31(7):583-94. Epub 2014 May 23 doi: 10.1055/s-0034-1372428. PMID: 24858318

Therapy

Fetoscopic laser ablation in twin-to-twin transfusion syndrome: tips for counselling.
Pajno C, D'Ambrosio V, D'Alisa R, DI Mascio D, Vena F, Corno S, Spiniello L, Martinino A, Manicone F, Muzii L, Brunelli R, Giancotti A
Minerva Obstet Gynecol 2021 Apr;73(2):247-252. doi: 10.23736/S2724-606X.20.04714-0. PMID: 33851804
Error traps in fetal surgery.
Peiro JL, Crombleholme TM
Semin Pediatr Surg 2019 Jun;28(3):143-150. Epub 2019 Apr 25 doi: 10.1053/j.sempedsurg.2019.04.012. PMID: 31171149
Update on twin-to-twin transfusion syndrome.
Bamberg C, Hecher K
Best Pract Res Clin Obstet Gynaecol 2019 Jul;58:55-65. Epub 2019 Jan 5 doi: 10.1016/j.bpobgyn.2018.12.011. PMID: 30850326
Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis.
Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, Asztalos E, Hack K, Lewi L, Lim A, Liem S, Norman JE, Morrison J, Combs CA, Garite TJ, Maurel K, Serra V, Perales A, Rode L, Worda K, Nassar A, Aboulghar M, Rouse D, Thom E, Breathnach F, Nakayama S, Russo FM, Robinson JN, Dodd JM, Newman RB, Bhattacharya S, Tang S, Mol BW, Zamora J, Thilaganathan B, Thangaratinam S; Global Obstetrics Network (GONet) Collaboration
BMJ 2016 Sep 6;354:i4353. doi: 10.1136/bmj.i4353. PMID: 27599496Free PMC Article
Future Directions in the Management of Twin-to-Twin Transfusion Syndrome.
Cincotta R, Kumar S
Twin Res Hum Genet 2016 Jun;19(3):285-91. Epub 2016 Apr 29 doi: 10.1017/thg.2016.32. PMID: 27125296

Prognosis

Ultrasonographic Diagnosis of Twin-to-Twin Transfusion Syndrome.
Reyna-Villasmil E, Briceño-Pérez C, Briceño-Sanabria JC
Am J Perinatol 2024 Apr;41(5):531-538. Epub 2022 Mar 9 doi: 10.1055/s-0042-1744259. PMID: 35263768
Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders.
Rana S, Burke SD, Karumanchi SA
Am J Obstet Gynecol 2022 Feb;226(2S):S1019-S1034. Epub 2020 Oct 20 doi: 10.1016/j.ajog.2020.10.022. PMID: 33096092Free PMC Article
Twin-to-Twin Transfusion Syndrome: A Case Report.
Bautista TN, Krebs TL, Jnah A, Newberry D
Neonatal Netw 2018 Sep;37(5):292-302. Epub 2018 Sep 1 doi: 10.1891/0730-0832.37.5.292. PMID: 30567811
Early prediction of twin-to-twin transfusion syndrome: systematic review and meta-analysis.
Stagnati V, Zanardini C, Fichera A, Pagani G, Quintero RA, Bellocco R, Prefumo F
Ultrasound Obstet Gynecol 2017 May;49(5):573-582. doi: 10.1002/uog.15989. PMID: 27270878
Twin-to-twin transfusion syndrome: prenatal diagnosis and treatment.
Benoit RM, Baschat AA
Am J Perinatol 2014 Aug;31(7):583-94. Epub 2014 May 23 doi: 10.1055/s-0034-1372428. PMID: 24858318

Clinical prediction guides

The heart after surviving twin-to-twin transfusion syndrome.
Torres X, Bennasar M, Bautista-Rodríguez C, Martínez-Portilla RJ, Gómez O, Micheletti T, Eixarch E, Crispi F, Gratacós E, Martínez JM
Am J Obstet Gynecol 2022 Sep;227(3):502.e1-502.e25. Epub 2022 Mar 26 doi: 10.1016/j.ajog.2022.03.049. PMID: 35351412
Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders.
Rana S, Burke SD, Karumanchi SA
Am J Obstet Gynecol 2022 Feb;226(2S):S1019-S1034. Epub 2020 Oct 20 doi: 10.1016/j.ajog.2020.10.022. PMID: 33096092Free PMC Article
Early prediction of twin-to-twin transfusion syndrome: systematic review and meta-analysis.
Stagnati V, Zanardini C, Fichera A, Pagani G, Quintero RA, Bellocco R, Prefumo F
Ultrasound Obstet Gynecol 2017 May;49(5):573-582. doi: 10.1002/uog.15989. PMID: 27270878
Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis.
Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, Asztalos E, Hack K, Lewi L, Lim A, Liem S, Norman JE, Morrison J, Combs CA, Garite TJ, Maurel K, Serra V, Perales A, Rode L, Worda K, Nassar A, Aboulghar M, Rouse D, Thom E, Breathnach F, Nakayama S, Russo FM, Robinson JN, Dodd JM, Newman RB, Bhattacharya S, Tang S, Mol BW, Zamora J, Thilaganathan B, Thangaratinam S; Global Obstetrics Network (GONet) Collaboration
BMJ 2016 Sep 6;354:i4353. doi: 10.1136/bmj.i4353. PMID: 27599496Free PMC Article
Renal tubular dysgenesis.
Gubler MC
Pediatr Nephrol 2014 Jan;29(1):51-9. Epub 2013 May 1 doi: 10.1007/s00467-013-2480-1. PMID: 23636579

Recent systematic reviews

Fetoscopic laser photocoagulation versus expectant management for stage I twin-to-twin transfusion syndrome: A systematic review and meta-analysis.
Nassr AA, Hessami K, Zargarzadeh N, Krispin E, Mostafaei S, Habli MA, Papanna R, Emery SP, Shamshirsaz AA
Prenat Diagn 2023 Aug;43(9):1229-1238. Epub 2023 Aug 4 doi: 10.1002/pd.6413. PMID: 37539833
Incidence and outcome of prenatal brain abnormality in twin-to-twin transfusion syndrome: systematic review and meta-analysis.
Sileo FG, Curado J, D'Antonio F, Benlioglu C, Khalil A
Ultrasound Obstet Gynecol 2022 Aug;60(2):176-184. doi: 10.1002/uog.24895. PMID: 35233861
Early prediction of twin-to-twin transfusion syndrome: systematic review and meta-analysis.
Stagnati V, Zanardini C, Fichera A, Pagani G, Quintero RA, Bellocco R, Prefumo F
Ultrasound Obstet Gynecol 2017 May;49(5):573-582. doi: 10.1002/uog.15989. PMID: 27270878
Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis.
Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, Asztalos E, Hack K, Lewi L, Lim A, Liem S, Norman JE, Morrison J, Combs CA, Garite TJ, Maurel K, Serra V, Perales A, Rode L, Worda K, Nassar A, Aboulghar M, Rouse D, Thom E, Breathnach F, Nakayama S, Russo FM, Robinson JN, Dodd JM, Newman RB, Bhattacharya S, Tang S, Mol BW, Zamora J, Thilaganathan B, Thangaratinam S; Global Obstetrics Network (GONet) Collaboration
BMJ 2016 Sep 6;354:i4353. doi: 10.1136/bmj.i4353. PMID: 27599496Free PMC Article
Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis.
Khalil A, Cooper E, Townsend R, Thilaganathan B
Twin Res Hum Genet 2016 Jun;19(3):207-16. Epub 2016 May 3 doi: 10.1017/thg.2016.33. PMID: 27137946

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Reviews

    Related information

    • MeSH
      Related Medical Subject Headings
    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...