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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
Twin-to-twin transfusion syndrome (TTTS).
WAPM Consensus Group on Twin-to-Twin Transfusion, Baschat A, Chmait RH, Deprest J, Gratacós E, Hecher K, Kontopoulos E, Quintero R, Skupski DW, Valsky DV, Ville Y
J Perinat Med 2011 Mar;39(2):107-12. Epub 2010 Dec 13 doi: 10.1515/jpm.2010.147. PMID: 21142846

Recent clinical studies

Etiology

Twin Anemia-Polycythemia Sequence (TAPS): From Basic Research to Clinical Practice.
da Silva Rocha J, Guedes-Martins L, Cunha A
Curr Vasc Pharmacol 2023;21(2):91-105. doi: 10.2174/1570161121666230131112930. PMID: 36718965
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
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
Perinatal outcome after fetoscopic laser surgery for twin-to-twin transfusion syndrome in triplet pregnancies.
D'Antonio F, Thilaganathan B, Toms J, Manzoli L, Bhide A, Papageorghiou A, Khalil A
BJOG 2016 Feb;123(3):328-36. Epub 2015 Aug 11 doi: 10.1111/1471-0528.13553. PMID: 26265264
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

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
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
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
Intrauterine surgery--choices and limitations.
Diemert A, Diehl W, Glosemeyer P, Deprest J, Hecher K
Dtsch Arztebl Int 2012 Sep;109(38):603-38. Epub 2012 Sep 21 doi: 10.3238/arztebl.2012.0603. PMID: 23093990Free PMC Article

Therapy

Effects and outcomes of septostomy in twin-to-twin transfusion syndrome after fetoscopic laser therapy.
Li WF, Chao AS, Chang SD, Cheng PJ, Yang LY, Chang YL
BMC Pregnancy Childbirth 2019 Nov 1;19(1):397. doi: 10.1186/s12884-019-2555-5. PMID: 31675920Free 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
No. 260-Ultrasound in Twin Pregnancies.
Morin L, Lim K
J Obstet Gynaecol Can 2017 Oct;39(10):e398-e411. doi: 10.1016/j.jogc.2017.08.014. PMID: 28935062
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
Intrauterine surgery--choices and limitations.
Diemert A, Diehl W, Glosemeyer P, Deprest J, Hecher K
Dtsch Arztebl Int 2012 Sep;109(38):603-38. Epub 2012 Sep 21 doi: 10.3238/arztebl.2012.0603. PMID: 23093990Free PMC Article

Prognosis

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
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
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
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
Preterm arterial ischemic stroke.
Benders MJ, Groenendaal F, De Vries LS
Semin Fetal Neonatal Med 2009 Oct;14(5):272-7. Epub 2009 Aug 4 doi: 10.1016/j.siny.2009.07.002. PMID: 19656748

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
No. 260-Ultrasound in Twin Pregnancies.
Morin L, Lim K
J Obstet Gynaecol Can 2017 Oct;39(10):e398-e411. doi: 10.1016/j.jogc.2017.08.014. PMID: 28935062
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
Perinatal outcome after fetoscopic laser surgery for twin-to-twin transfusion syndrome in triplet pregnancies.
D'Antonio F, Thilaganathan B, Toms J, Manzoli L, Bhide A, Papageorghiou A, Khalil A
BJOG 2016 Feb;123(3):328-36. Epub 2015 Aug 11 doi: 10.1111/1471-0528.13553. PMID: 26265264
Diagnosis and management of fetal heart failure.
Thakur V, Fouron JC, Mertens L, Jaeggi ET
Can J Cardiol 2013 Jul;29(7):759-67. Epub 2013 May 8 doi: 10.1016/j.cjca.2013.02.001. PMID: 23664320

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
Planned early delivery versus expectant management for monoamniotic twins.
Shub A, Walker SP
Cochrane Database Syst Rev 2015 Apr 23;2015(4):CD008820. doi: 10.1002/14651858.CD008820.pub2. PMID: 25906204Free PMC Article

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