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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
Management of twin-to-twin transfusion syndrome.
Selman TJ, Morris RK, Kilby MD
Arch Dis Child Fetal Neonatal Ed 2011 Sep;96(5):F318-20. Epub 2011 Jun 15 doi: 10.1136/adc.2010.207738. PMID: 21677279

Recent clinical studies

Etiology

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
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
Twin-to-twin transfusion syndrome.
Andrade CM, Guazzelli CA, Moron AF
Int J Gynaecol Obstet 2007 Aug;98(2):154-5. Epub 2007 Jun 18 doi: 10.1016/j.ijgo.2007.04.012. PMID: 17574256
Invasive antenatal interventions in complicated multiple pregnancies.
Lewi L, Jani J, Deprest J
Obstet Gynecol Clin North Am 2005 Mar;32(1):105-26, x. doi: 10.1016/j.ogc.2004.10.008. PMID: 15644293

Diagnosis

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: what nurses need to know.
Jackson KM, Mele NL
Nurs Womens Health 2009 Jun;13(3):224-32; quiz 233. doi: 10.1111/j.1751-486X.2009.01423.x. PMID: 19523136
Twin-to-twin transfusion syndrome: new perspectives.
Lopriore E, Vandenbussche FP, Tiersma ES, de Beaufort AJ, de Leeuw JP
J Pediatr 1995 Nov;127(5):675-80. doi: 10.1016/s0022-3476(95)70152-4. PMID: 7472815

Therapy

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
Twin-to-Twin Transfusion Syndrome: From Observational Evidence to Randomized Controlled Trials.
Stirnemann JJ, Chalouhi G, Ville Y
Twin Res Hum Genet 2016 Jun;19(3):268-75. Epub 2016 Apr 14 doi: 10.1017/thg.2016.22. PMID: 27075108
Fetal surgery: an overview.
Sala P, Prefumo F, Pastorino D, Buffi D, Gaggero CR, Foppiano M, De Biasio P
Obstet Gynecol Surv 2014 Apr;69(4):218-28. doi: 10.1097/OGX.0000000000000061. PMID: 25101597
Invasive antenatal interventions in complicated multiple pregnancies.
Lewi L, Jani J, Deprest J
Obstet Gynecol Clin North Am 2005 Mar;32(1):105-26, x. doi: 10.1016/j.ogc.2004.10.008. PMID: 15644293

Prognosis

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
Management of twin-to-twin transfusion syndrome.
Selman TJ, Morris RK, Kilby MD
Arch Dis Child Fetal Neonatal Ed 2011 Sep;96(5):F318-20. Epub 2011 Jun 15 doi: 10.1136/adc.2010.207738. PMID: 21677279
Syndromes in twins.
D'Alton ME, Simpson LL
Semin Perinatol 1995 Oct;19(5):375-86. doi: 10.1016/s0146-0005(05)80015-1. PMID: 8821025
Twin-to-twin transfusion syndrome: new perspectives.
Lopriore E, Vandenbussche FP, Tiersma ES, de Beaufort AJ, de Leeuw JP
J Pediatr 1995 Nov;127(5):675-80. doi: 10.1016/s0022-3476(95)70152-4. PMID: 7472815
TWIN-TO-TWIN TRANSFUSION SYNDROME.
BECKER AH, GLASS H
Am J Dis Child 1963 Dec;106:624-9. doi: 10.1001/archpedi.1963.02080050626015. PMID: 14063715

Clinical prediction guides

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
Twin-to-Twin Transfusion Syndrome: From Observational Evidence to Randomized Controlled Trials.
Stirnemann JJ, Chalouhi G, Ville Y
Twin Res Hum Genet 2016 Jun;19(3):268-75. Epub 2016 Apr 14 doi: 10.1017/thg.2016.22. PMID: 27075108
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

Perinatal outcomes following fetoscopic laser surgery for early twin-to-twin transfusion syndrome: Systematic review and meta-analysis.
Mustafa HJ, Aghajani F, Patrick E, Baerz MM, Arias-Sánchez P, Khalil A
Acta Obstet Gynecol Scand 2024 May;103(5):824-831. Epub 2024 Feb 28 doi: 10.1111/aogs.14806. PMID: 38415823Free PMC Article
Outcome of twin-to-twin transfusion syndrome in monochorionic monoamniotic twin pregnancy: systematic review and meta-analysis.
Murgano D, Khalil A, Prefumo F, Mieghem TV, Rizzo G, Heyborne KD, Melchiorre K, Peeters S, Lewi L, Familiari A, Lopriore E, Oepkes D, Murata M, Anselem O, Buca D, Liberati M, Hack K, Nappi L, Baxi LV, Scambia G, Acharya G, D'antonio F
Ultrasound Obstet Gynecol 2020 Mar;55(3):310-317. doi: 10.1002/uog.21889. PMID: 31595578
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

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