Twin to Twin Transfer Syndrome (TTTS) is a rare condition that can only happen in multiples that share a placenta. Without treatment, it's almost always fatal to both of the babies. With treatment, there's a 60% chance that both twins will make it.
In TTTS, the babies start to share blood vessels within the placenta. It's okay if they share the placenta equally. If they don't, one baby "donates" blood and fluid to the other. This stresses the babies to the point of causing things like heart failure, cerebral palsy, and other conditions. If they make it to birth, they are born very sick. If they make it to birth, they're usually premature on top of being very sick.
In our case, Wyatt was the donor and Cameron was the recipient.
First, there was a discordance in their fluid levels. Cameron had higher levels than Wyatt. Normal is greater than 2cm, less than 8cm when they measure the deepest pockets of fluid in their amniotic sacs. When I was about 22 weeks along, they noticed Cameron was flirting with the higher limit and Wyatt was close to the lower limit. Twins can have fluid discordance and be normal and healthy. Or it can be a sign of something dangerous. My doctor increased my frequency of visits from once every two weeks to every week to monitor things more closely.
To diagnose TTTS, they also look at their hearts, how blood is flowing, bladder size, and a few other things. Often the donor will be smaller than the recipient, but my doctor said that criteria isn't considered anymore. It's mostly changes in the heart, abnormal blood flow, a visible bladder, and fluid around the heart or brain (hydrops).
I was 24 weeks and 4 days along when my doctor said he could see some stiffening in Cameron's heart and considering that plus the fluid discordance which was now over 8cm for Cameron, he recommended laser surgery for TTTS.
The laser surgery for TTTS has been around since the late '80's and has good success rates. They take a laser and burn the connections between the twins basically creating two placentas. Then they watch you for a day or two to make sure you don't go into labor. The hope is that you go on to have a normal healthy pregnancy. For 90% of cases, families end up taking home a healthy baby. For 60% of cases, families take home both babies.
The closest place was 12 hours away. It was a Friday and he set up the appointment for Monday. He wanted me to fast in case they decided to take me to surgery that day. Or it would be Tuesday. On Monday I'd be 25 weeks and their cut off was 26 weeks.
I remember getting home to look up the success rates. I started to cry. It was scary considering 40% of the cases, one of the twins dies because there wasn't enough placenta for the baby to survive. I love both my boys and while there was no question that I needed to have this surgery, 40% seemed awfully high.
We quickly made plans to fly out and have the surgery. We found a place to board the dogs. My husband, Nick, worked out a flight and hotel. We were all set. I was surprised by how smooth it all went.
And then I started spotting...
