Name of the Condition

• Fetus-to-Fetus Placental Transfusion Syndrome, also known as Twin-to-Twin Transfusion Syndrome (TTTS).

Summary

• Fetus-to-Fetus placental transfusion syndrome is a prenatal condition affecting identical twins who share a placenta. It involves an imbalanced blood flow between the twins, resulting in one twin receiving too much blood and the other too little. This can cause serious complications if not treated.

Causes

• The condition is caused by abnormal blood vessel connections in the shared placenta of monochorionic twin pregnancies, leading to unequal blood distribution.

Risk Factors

• Occurs exclusively in monochorionic-diamniotic twin pregnancies where the twins share a single placenta.
• Higher risk in pregnancies where twins develop from a single fertilized egg.

Symptoms

• Symptoms are not experienced directly but may be detected via ultrasound showing differences in amniotic fluid levels or growth discrepancies between twins.

Diagnosis

• Typically diagnosed through prenatal ultrasound, evaluating amniotic fluid levels, size discrepancies, bladder size, and blood flow patterns between the twins.

Treatment Options

• Fetoscopic laser surgery to seal abnormal blood vessels in the placenta.
• Amnioreduction to decrease excess amniotic fluid, alleviating pressure.
• Serial amniocentesis in specific cases to manage fluid balance.

Prognosis and Follow-Up

• Prognosis depends on the severity and timely management. Early diagnosis and treatment improve outcomes significantly.
• Regular monitoring through ultrasounds is key to managing the condition and ensuring the health of both twins.

Complications

• Without treatment, it can lead to heart failure in the donor twin, high blood pressure in the recipient twin, and even fetal demise for one or both twins.

Lifestyle & Prevention

• While the condition cannot be prevented due to its nature, early prenatal care and regular monitoring can help in early detection and management.

When to Seek Professional Help

• Immediate medical attention is advised if routine ultrasounds indicate any abnormalities regarding fluid levels or growth patterns in twin pregnancies.

Additional Resources

• March of Dimes: www.marchofdimes.org
• TTTS Foundation: www.tttsfoundation.org

Tips for Medical Coders

• Ensure proper coding by confirming twin pregnancies and identifying shared placental connections through medical records.
• Beware of coding errors, such as confusing this condition with other complications unique to twin pregnancies.