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Twin-to-Twin Transfusion Syndrome (TTTS)


Twin-to-Twin transfusion syndrome (TTTS) is a rare, in utero condition that involves an uneven blood flow between identical twins sharing the same placenta. The placenta attaches to the inside of the uterus during pregnancy and connects to the fetus by the umbilical cord to deliver oxygen and nutrients from the mother to the baby. In TTTS, one twin (donor twin) gives too much blood to the other twin (recipient twin) due to placental vessel connections. There is no known genetic or other cause for why this condition develops.

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Our Program

Twin-to-twin transfusion syndrome is one of many complex procedures our Fetal Care Center specialists treat and we are the only center in the state offering laser fetoscopy treatment. This procedure uses an instrument equipped with a laser to burn the unequal blood vessel connections and excessive amniotic fluid is then drained from the area around the recipient twin.


This progressive condition typically develops between weeks 16 and 26 of pregnancy and is detected by ultrasound. TTTS is diagnosed by measuring levels of amniotic fluid to see if one twin has a higher level than the other does. Another sign of this is drastically different weights or sizes of twins in the womb.

It is important to diagnose TTTS versus other rare disorders that can occur in identical twin pregnancies, including twin anemia polycythemia sequence (TAPS). Our team of specialists are experienced in detecting and diagnosing TTTS in order to assure the proper steps are taken to treat the mother and baby.


Laser fetoscopy is the most effective method of treatment for TTTS and can be safely performed until 26 weeks of gestation. We are equipped with skilled surgeons and advanced technology to perform this specialized procedure for those with this condition. We are the only center in the state to offer this advanced prenatal treatment to families who have received the diagnosis of TTTS.

In this procedure, a small incision is made in the mother’s abdomen so a small instrument can be inserted to burn the unequal blood vessel connections. Then, excessive amniotic fluid is drained from the area around the recipient twin using a vacuum assisted device. Our Fetal Care Center treats mothers and babies referred to us from all over the Northeast for TTTS and other conditions in developing babies. We ensure the greatest of care for our smallest patients.

Yale School of Medicine

Yale New Haven Health is proud to be affiliated with the prestigious Yale University and its highly ranked Yale School of Medicine.