WHAT ARE THE WARNING SIGNS?

Warning signs in the mother include:

• The sensation of a rapid growth of the womb
• A uterus that measures large for dates
• Abdominal pain or tightness, or uterine contractions
• Sudden increases in body weight
• Hand and leg swelling in early pregnancy

Warning signs in the twins appear on ultrasound scans and include:

• Evidence of a monochorionic or shared placenta
• A single placenta
• Same sex twins
• A thin, hard to see, dividing membrane

Evidence of TTTS

• Polyhydramnios (excess amniotic fluid) in the sac of one twin
• Oligohydramnios (decreased to no amniotic fluid) in the sac of the other twin
• Size differences (discordance) in the twins
• Hydrops fetalis (water in one baby’s body from heart failure)

It is crucial for parents with a multiple gestation to determine their placental type early. With monochorionic twins, you should watch carefully for the warning signs listed above. Since TTTS is a high-risk problem that can happen quickly and at any time in pregnancy, frequent examinations and ultrasound scans are necessary to catch the problem early. Many physicians are unaware of the warning signs so your awareness is critical.

THE FOUNDATION ADVOCATES WEEKLY ULTRASOUNDS WITH A PERINATOLOGIST FROM 16 WEEKS GESTATION THROUGH DELIVERY TO LOOK FOR PLACENTAL SHARE PROBLEMS AND TTTS.