PRENATAL-DIAGNOSIS AND TREATMENT OF TWIN-TWIN TRANSFUSION SYNDROME

Twin-twin transfusion syndrom (TTTS) is a serious complication of mono chorionic twin pregnancies. It is the result of an unbalanced transfus ion of blood across placental vascular anastomoses. TTTS appears predo minantly in the second trimester of pregnancy characterized by discord ance of growth as well as polyhydramnios in the recipient and oligo-/a nhydramnios in the donor. Prenatal diagnosis is possible by non-invasi ve and invasive methods. The prognosis of the untreated TTTS is very p oor. Serial amniocenteses and laser therapy are used resulting in surv ival rates of about 60%. Intrauterine death of one twin is associated with a high risk of morbidity in the surviving twin. Monochorionic twi ns have to be identified in early pregnancy. Close surveillance is nec essary to diagnose TTTS at an early stage of the disease.