How long is the risk for TTTS?

I was just wondering if there is a point with mono/di twins that you can stop worrying about having TTTS if you haven't had any complications so far in the pregnancy? I am 21 weeks tomorrow and was wondering if I am going to need to keep up the 3 protein shakes a day and horizontal rest (when I can between chasing my 9 month old) throughout my entire pregnancy? What is the lastest ( besides acute at delivery) that you have heard of someone developing the syndrome? Thanks fo any info you can pass on. Melanie

 

I think most cases are seen by 26 weeks with TTTS, but it can still happen suddenly. Seems like acute TTTS is TTTS that happens anytime after 28 weeks. . . someone correct me if I'm wrong.

I would say that as long as things are being monitored, try not to worry. I would keep up the high protein stuff regardless because twin pregnancy is more demanding on your body in general, rest when you can, but don't worry so much if things are going well! TTTS happens, but it is still pretty rare considering.

(Of course, I'm one of the "lucky" ones to deal with it.)

 

TTTS can show itself throughtout the pregnancy. It can easily show up at 30+ weeks BUT at that point, delivering the twins gives them a good chance. It is when it is diagnosed and not much can be done (therapies, delivery) that is the real worry, IMO.

 

My boys were born at 34 weeks and TTTS didnt show up until just that same week, there was a 2 lb size discordance which was hard to determine if it was the TTTS or the heart defect in baby b. But like a pp said .. after that point you just deliver.

Good luck !

 

Ttts can show up any time even during delivery being acute ttts at that time.

 

My doc wantched me like a hawk till the end. Even during the last month they kept sending me for ultrasounds to monitor the fluid levels for each baby. They actually got even more vigilant in the end due to the possibility for acute TTTS. But all was well - thank goodness. I wouldnt worry - there is nothing you can do - you can drink protein shakes until the cows come home and still have TTTS. So, make sure your docs are ontop of it - in terms of monitoring luid levels - and relax - its out of your control. Short answer to your question the risk is over when the babies are in your arms.

 

Like the others said, it can happen at any point.

I believe that the latest they will do the laser surgery is 26 weeks, so after that, if TTTS appears they will likely just watch and then deliver the babies. It's before 26 weeks that they watch closely because there is something they can do to save the babies (the surgery). They should watch closely after that too, since it can happen any time, and that's not just acute TTTS!

Keep up the good work - maybe you are preventing it by all your hard work! I know how hard it is to keep yourself resting!

You can do it!
Jenny

 

I think the answers above are all good... i think there IS no relax time, but.... as long as you are being monitored well, I think after 28 weeks is good for relaxing, because if it DOES show up your babies have a better chance of making it if emergency birth is required.

 

QUOTE(ferfischer @ Jun 9 2008, 11:00 AM) [snapback]817409[/snapback]
Like the others said, it can happen at any point.

I believe that the latest they will do the laser surgery is 26 weeks, so after that, if TTTS appears they will likely just watch and then deliver the babies. It's before 26 weeks that they watch closely because there is something they can do to save the babies (the surgery). They should watch closely after that too, since it can happen any time, and that's not just acute TTTS!

Keep up the good work - maybe you are preventing it by all your hard work! I know how hard it is to keep yourself resting!

You can do it!
Jenny



This is exactly what I was going to write. I was monitored for my entire pregnancy and my water broke at 33wk. Baby B had IUGR. Turns out I had TWO placentas but they were fused! I'm so glad I was monitored so closely and got to see my boys so much. After my 28th week, my peri had me go 3 weeks without seeing him since the fluids were looking better. It was the scariest 3 weeks of my life. About halfway through that 3 weeks, I panicked thinking I hadn't felt one of the babies move in a few days and made them do another ultrasound. Every night when the boys woke me up to feed them, I wouldn't be bothered because I was so happy not to be worrying about them and TTTS anymore. Probably more info than you wanted, but thought I'd share.

 

QUOTE(mstofko21 @ Jun 8 2008, 09:30 PM) [snapback]816843[/snapback]
I was just wondering if there is a point with mono/di twins that you can stop worrying about having TTTS if you haven't had any complications so far in the pregnancy? I am 21 weeks tomorrow and was wondering if I am going to need to keep up the 3 protein shakes a day and horizontal rest (when I can between chasing my 9 month old) throughout my entire pregnancy? What is the lastest ( besides acute at delivery) that you have heard of someone developing the syndrome? Thanks fo any info you can pass on. Melanie


Hi I had TTTS with my boys and it was diganosed at 26 weeks, I had a doctors appointment the week before and complained of feeling short of breath and uncomfortable because all my clothes all of sudden didn't fit...she sent me home and did not schedule any additional ultrasounds! she claimed it was because I was having twins and nothing to worry about.which was very wrong, I went for a regular ultrasound where they found twin A head down and I was 5 cm dialated, I was rushed to hospital where they found I had a TTTS stage 1, thankfully I was able to hold off and had the boys at 31 weeks 5 days! but it was a long time to get there. I had serial amnioreductions. I actually spent 2 weeks in L&D and the additional 3 weeks on the high risk floor.
Make sure your doctor sends you for more ultrasounds, ask a lot of questions. & be pushy!

 

Thanks for the advice ladies

 

QUOTE(mstofko21 @ Jun 8 2008, 06:30 PM) [snapback]816843[/snapback]
I was just wondering if there is a point with mono/di twins that you can stop worrying about having TTTS if you haven't had any complications so far in the pregnancy? I am 21 weeks tomorrow and was wondering if I am going to need to keep up the 3 protein shakes a day and horizontal rest (when I can between chasing my 9 month old) throughout my entire pregnancy? What is the lastest ( besides acute at delivery) that you have heard of someone developing the syndrome? Thanks fo any info you can pass on. Melanie



Melanie,

Is there anything other than carrying the mono/di twinnies that is putting you at risk for TTTS? Just wondering because i have mono/di's and haven't been told to up the protein or get horizontal rest. Did you have early detection of it? (Hope not). Sorry to be a scaredy cat, I'm just worried that I should be doing the same and my appointment to ask the OB is not for another week and a half. Thank you! =)

 

QUOTE(Molly_US @ Jun 12 2008, 02:54 PM) [snapback]823665[/snapback]
Melanie,

Is there anything other than carrying the mono/di twinnies that is putting you at risk for TTTS? Just wondering because i have mono/di's and haven't been told to up the protein or get horizontal rest. Did you have early detection of it? (Hope not). Sorry to be a scaredy cat, I'm just worried that I should be doing the same and my appointment to ask the OB is not for another week and a half. Thank you! =)



No in fact I am doing extremely well. There is always a risk for ttts with mono/di or mono/mono twins. The risk is actually only 10-15% according to Dr. DeLia who is an expert on the subject and performs the surgeries. I was a bit concerned when we found out the babies were sharing a placenta and all of the info I had found in twins books was so negative and scary I decided to contact Dr. Delia myself. He did a history over the phone and gave me a bunch of information. His recommendation to me was to get as much horizontal rest as possible and to drink 3 high protein drinks a day (boost/ensure). This not only helps with prevention and treatment of mild TTTS but it can help you in the case that you do deliver early. He was a very good resource. My OB is not overly concerned as the babies have been measuring consistently large and their fluid levels have been great, although I do get a level 2 u/s every month and an u/s when I go see her about every 3 weeks as well. I also have started to see her every 2 weeks after week 20. I would bring it up at your next OB appt and just inquire about how they are planning on monitoring you. The rest, protein drinks, and hydration never hurt anyone I am sure so you might as well do it I am a pediatric nurse on the infants and toddlers unit and I have only had one pt. in 5 years that had ttts and we have tons of preemie and multiples that we care for. Just knowing that it could happen was what prompted me to learn as much about it as I can. Congrats on your babies and try not to worry too much.