Twin-to-Twin Transfusion Syndrome (TTTS)
At Banner Good Samaritan, one of the newest techniques in the field of fetal medicine is an intrauterine laser procedure to treat a very severe condition called Twin-to-Twin Transfusion Syndrome (TTTS).
This condition occurs when there is an abnormal connection in the circulation system between identical (but physically separate) twins. One twin may donate much of its blood to its fellow twin, such that the unborn child experiences difficulty in growing and producing amniotic fluid. The recipient may have trouble handling the excessive blood flow and produce too much amniotic fluid. If allowed to progress without treatment, one twin will die in about 70 percent of cases, and the second twin has a subsequent 50-percent risk of death, as well.
Maternal-Fetal specialist William Clewell, MD has used this laser intervention treatment for twin-twin transfusion for several years. They are also working with the Banner Simulation System to develop the world’s first simulation model to train other physicians in this technique.
In this procedure, a small camera with an attached laser fiber is inserted directly through the mother's abdomen into the womb. The camera is used to visually scan the entire shared placenta to identify the interconnecting blood vessels between the twins. The laser fiber is then used to burn these vessels, thus “disconnecting” the blood flow between each twin.
This technique has been well studied in Europe, and has been found to be effective in saving at least one, if not both, developing twins.
The technique can also preventing brain damage that may result from this condition.
Although this procedure has been considered aggressive, it is now accepted among fetal therapists as the most effective treatment for TTTS.