• Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Birth Injury Lawyers Alliance

Just another WordPress site

Contact a Birth Injury Lawyer
For a Free Consultation
TOLL FREE: 1-800-300-BILA (2452)
  • Home
  • Birth Injuries
    • Birth Asphyxia
    • Cerebral Palsy Lawyers
      • Early Signs
      • Lawsuits and Settlements
    • Developmental Delays
      • Causes
      • Signs and Examples
      • Treatment and Therapy
    • Hypoxic Ischemic Encephalopathy (HIE)
      • Signs and Symptoms
      • Therapy and Treatment
      • Lawsuits
      • Long-Term Effects
    • Jaundice, Kernicterus & Hyperbilirubinemia
    • Hypoglycemia in Babies
    • Shoulder Dystocia
    • Failure to Progress During Labour and Delivery
    • Negligence in Antenatal (Prenatal) Care
    • Other Birth Injuries
  • Legal Team
    • Alliance Lawyers
    • In the Community
    • How to Become Involved
    • Office Locations
      • British Columbia
      • Edmonton
      • Manitoba
      • Ontario
      • Nova Scotia
  • Lawsuits
  • Case Results
  • FAQ
  • Support
  • Blog
  • Contact
  • Home
  • Birth Injuries
    • Birth Asphyxia
    • Cerebral Palsy Lawyers
      • Early Signs
      • Lawsuits and Settlements
    • Developmental Delays
      • Causes
      • Signs and Examples
      • Treatment and Therapy
    • Hypoxic Ischemic Encephalopathy (HIE)
      • Signs and Symptoms
      • Therapy and Treatment
      • Lawsuits
      • Long-Term Effects
    • Jaundice, Kernicterus & Hyperbilirubinemia
    • Hypoglycemia in Babies
    • Shoulder Dystocia
    • Failure to Progress During Labour and Delivery
    • Negligence in Antenatal (Prenatal) Care
    • Other Birth Injuries
  • Legal Team
    • Alliance Lawyers
    • In the Community
    • How to Become Involved
    • Office Locations
      • British Columbia
      • Edmonton
      • Manitoba
      • Ontario
      • Nova Scotia
  • Lawsuits
  • Case Results
  • FAQ
  • Support
  • Blog
  • Contact
Call
Contact
Blog
Home / Types of Birth Injuries / Twin to Twin Transfusion Syndrome

Twin to Twin Transfusion Syndrome

What is twin to twin transfusion syndrome and how can it place your babies at risk?

Twin pregnancies can occur as either dizygotic (fraternal twins) or monozygotic (identical twins). In the case of a dizygotic (fraternal) pregnancy the twins are the result of fertilization of two separate eggs.  In the case of monozygotic (identical) pregnancy the twins are the result of fertilization of one egg that splits at some point after fertilization.

In either case, each fetus may be surrounded by two sacs during pregnancy, an inner amniotic sac and an outer chorionic sac. All dizygotic (fraternal) twins are di-chorionic and di-amniotic, meaning that there are two separate chorionic sacs and two amniotic sacs present.  Di-chorionic twins will also have separate placentas for each twin.

Potential health risks to identical twins

Monozygotic (identical) twins can have two chorionic sacs (referred to as di-chorionic) and two amniotic sacs (referred to as di-amniotic), or one of each, depending on the timing of when the embryo splits.  If there is one chorionic sac, it is described as mono-chorionic.  Of significance in mono-chorionic cases, the twins will share a single placenta.

When identifying twins, it becomes critically important to determine whether they are di-chorionic or mono-chorionic so as to determine the number of placenta. Twins that share a placenta (mono-chorionic) are at an increased risk of developing a complication of the placenta known as twin to twin transfusion syndrome or TTTS.

In such a situation where there is a sharing of a single placenta, depending on the development of the fetus, the blood supplies of mono-chorionic (identical) twins can become connected so that the twins share a circulation.  Twin to twin transfusion syndrome occurs when, depending on the number, type and direction of the inter-commuting blood vessels (anastomoses), there can be an unbalanced flow of blood between the fetuses. That is to say, one twin gains some blood while the other loses blood (which gives reference to the name).

Donor and Recipient Twins

In some cases, this may result in only some mild difference in development, but in more severe cases, where the condition progresses, it may result in severe harm to one or both of the fetuses.  In such severe cases, the twin that is losing blood to its sibling (described as the donor twin) will not grow as well and will typically have less amniotic fluid, and the twin receiving the blood (described as the recipient twin) has the potential for increased growth and increased amniotic fluid as its urine output increases as a result of the additional blood flow.

Five Stages

If left untreated, TTTS may develop through five stages.  As it progresses and becomes more severe, significant harm can result to the fetuses in terms of serious developmental issues, cardiac failure, and ultimately the demise of one or both twins.

Potential treatment

Various treatments for this condition have existed over time but the current most accepted treatment is selective fetoscopic laser photocoagulation (SFLP) therapy of the communicating placental blood vessels. This procedure involves the use of laser ablation therapy to interrupt the blood vessels that allow the exchange of blood between the fetuses.  The chance of demise or other serious adverse outcomes to the fetuses can be greatly reduced through such therapy, provided that it is undertaken at an appropriate and timely stage.

Proper diagnosis critical

For these reasons, the proper identification of mono-chorionic (identical) pregnancies, which is usually to be done through the use of ultrasound at 11-13 weeks, is critical to the identification and ultimate treatment of TTTS. Follow up and careful monitoring of twin pregnancies that are identified as mono-chorionic (identical) are also critical for the proper and timely treatment of TTTS.

Therefore in some instances, a failure to have identified a mono-chorionic (identical) pregnancy and/or to properly monitor and follow up for the development of TTTS, may result in a preventable birth injury should harm result to one or both of the twins.

  • Author
  • Recent Posts
Charles Gluckstein
Toronto birth injury lawyer Charles Gluckstein was appointed President of the Ontario Trial Lawyers’ Association from 2013-2014. Since 2014, Best Lawyers® International has consistently recognized him as a leader in the personal injury field. In 2014 he was awarded the LEXPERT Zenith Award for Leading Personal Injury Lawyer in Practice Excellence, in recognition of thought leadership and the setting of new standards for the Personal Injury Bar. In its annual publication, the Canadian Legal LEXPERT® Directory has listed Charles as being repeatedly recommended by his peers in the area of personal injury for the Toronto region.

  • Twitter

Latest posts by Charles Gluckstein (see all)
  • Long Term Effects of a Nuchal Cord - May 6, 2022
  • Greatest Risks for Cerebral Palsy Occur Prior to Birth - August 28, 2020
  • Alberta to Begin Screening Newborns for Four New Conditions - September 27, 2019

Primary Sidebar

Take the First Steps Towards Peace of Mind

Talking with an experienced birth injury attorney about your child is a great first step in obtaining peace of mind. Consultations with our team of lawyers are always free and always confidential.
  • This field is for validation purposes and should be left unchanged.

Practice Areas

  • Cerebral Palsy Lawyers
  • Hypoxic Ischemic Encephalopathy (HIE)
  • Jaundice, Kernicterus & Hyperbilirubinemia
  • Autism Caused by Hypoxic Ischemic Encephalopathy (HIE)
  • Hypoglycemia in Babies
  • Brachial Plexus Injury Lawyer
  • Delayed Diagnosis of Heart Defects
  • Brachial Plexus & Erb’s Palsy Injury
  • Failure to Diagnose or Treat Preeclampsia
  • Fetal & Neonatal Stroke
  • Negligent Resuscitation of a Newborn
  • Meconium Aspiration Syndrome Lawyer
  • Newborn Infections
  • Periventricular Leukomalacia (PVL)
  • Trauma from Forceps & Vacuum
  • HIE Whole Body Cooling Treatment for Babies
  • Twin to Twin Transfusion Syndrome

Footer

Quick Links

  • Types of Birth Injuries
  • Legal Team
  • Case Results
  • Lawsuits
  • FAQ
  • Cerebral Palsy Support and Resources in Canada
  • Blog
  • Contact a BILA Lawyer

Canada Birth Injury Lawyers

TOLL FREE: 1-800-300-BILA (2452)

Sign-up And Get Notified Every Time We Post!

Loading

Copyright © 2023. Birth Injury Lawyers Alliance of Canada. All Rights Reserved.

Site Map|Privacy Policy|Terms of Use