Twin-Twin Transfusion Syndrome (TTTS) – Experience Matters

The Fetal Center at Children’s Memorial Hermann Hospital1 utilizes the experience and expertise of the nationally recognized team of affiliated fetal surgeons from McGovern Medical School at UTHealth Houston to provide the highest level of care to patients. As a national referral program, The Fetal Center currently receives patient referrals from 38 states and continues to serve as a leader in fetal diagnosis, fetal intervention and comprehensive fetal care for unborn babies with abnormalities. Learn more here »

Below is an overview of The Fetal Center’s clinical outcomes data for the treatment of TTTS. We strive to provide our patients and community with the most up-to-date information on our patient outcomes. Our hope is that the below data serves as a helpful resource to you when making informed decisions regarding your care.

For more information about our data, contact The Fetal Center, at (832) 325-7288.

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Total Placental Laser Ablations

 

Date range: September 2011 - December 9 , 2022. All fetoscopic placental laser ablations performed at the Fetal Center, including twins, triplets, higher-order multiples and TAPS. N=809

Overall Summary

Since 2011, The Fetal Center has performed 734 cases of laser photocoagulation for the treatment of TTTS at Children’s Memorial Hermann Hospital. The data below reflects surgical volume from September 2011 through December 5, 2022, and represents 707 patients with known outcomes at 30 days post-delivery.

Overall, survival of both babies is seen in 74% of cases, with survival of one twin in 15% of cases.

Total Number of Laser Case Procedures: 734
Number of Laser Repeat Cases 11
Number of Deliveries 710
Number of Deliveries with Known 30-Day Outcome 707

 

30-Day Post-Delivery Survival Rate by Gestational Age at Time of Fetal Intervention
Gestational Age at time of Procedure Total with Known Outcomes Pregnancies with Twin Survivors Pregnancies with One Twin Survivor Pregnancies with No Survivors
16 - 18 weeks 233 142 66% 44 20% 30 14%
19 - 21 weeks 270 193 78% 28 11% 28 11%
22 - 24 weeks 136 103 77% 16 12% 14 11%
25 - 27 weeks 60 45 80% 8 14% 3 5%
28 + weeks 8 5 62% 3 38% 0 0%
SUMMARY 707 488 74% 99 15% 75 11%

30-day post-delivery survival rate for placental laser ablations performed on monochorionic-diamniotic twin pregnancies.

 

30-Day Post-Delivery Survival Rate by TTTS Stage

The tables below reflect surgical volume from September 2011 through December 5, 2022, and represents data from 707 patients with known outcomes at 30 days post-delivery.

30-Day Post-Delivery Survival Rate by TTTS Stage

30-Day Post-Delivery Survival Rate by TTTS Stage
TTTS Stage Cases (percent of total cases*) Pregnancies with Twin Survivors Pregnancies with One Twin Survivor Pregnancies with No Survivors
Stage I 90 (13%) 73 (85%) 9 (10%) 4 (5%)
Stage II 197 (28%) 151 (80%) 16 (9%) 21 (11%)
Stage III 388 (55%) 242 (68%) 68 (19%) 47 (13%)
Stage IV 32 (4%) 22 (71%) 6 (19%) 3 (10%)

30-day post-delivery survival rate for placental laser ablations performed on monochorionic-diamniotic twin pregnancies.

 

TTTS 30-Day Post-Delivery Survival Rate by Cervical Length

The Fetal Center is committed to a highly aggressive approach to the overall survival of all twin pregnancies, treating some of the rarest and high-risk cases, including mothers with a cervical length of less than 1.5 cm, which increases a mother’s risk of spontaneous preterm birth by almost 50%, according to the American Journal of Obstetrics and Gynecology.

The below data reflects surgical volume from September 2011 through December 5, 2022. The data represents 701 patients with known outcomes at 30 days post-delivery, specifically highlighting outcomes based on mothers’ cervical length. As noted below, a cervical length of ≥ 1.5 cm was found in 95% of cases at The Fetal Center.

TTTS 30-Day Post-Delivery Survival Rate by Cervical Length

TTTS 30-Day Post-Delivery Survival Rate by Cervical Length
  Number of Cases* Pregnancies with Twin Survivors Pregnancies with One Twin Survivor Pregnancies with No Survivors
Number of cases with Cervical Length ≥ 1.5 cm 668 471 (75%) 94 (15%) 61 (10%)
Number of cases with Cervical Length ‹ 1.5 cm 33 15 (50%) 2 (7%) 13 (43%)
Total 701 486 (74%) 96 (15%) 74 (11%)

*Excludes six cases with no cervical length data.

Note – Those with a cervical length of less than 1.5cm are at increased risk and should be seen by a physician as soon as possible. Please call The Fetal Center at (832) 325-7288.

 

The data represents patient volume from September 2011 through December 5, 2022.

We encourage you to reach out to other health care centers to request and review their outcomes data in order to utilize the information available when choosing your health care options.

Published January 2023.

Contact Us

When you contact The Fetal Center, you will be in touch with a dedicated coordinator who will walk you through the process step-by-step and help you to understand every aspect of your care.

The Fetal Center at Children's Memorial Hermann Hospital
UT Professional Building
6410 Fannin, Suite 210
Houston, Texas 77030

Phone: (832) 325-7288
Toll free: (888) 818-4818
Fax: (713) 383-1464
Email: thefetalcenter@memorialhermann.org

To contact The Fetal Center at Children's Memorial Hermann Hospital, please fill out the form below.

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You!

Thank you for contacting The Fetal Center at Children’s Memorial Hermann Hospital. We have received your inquiry, and a team member will contact you soon.

If you need more immediate assistance, please call us during business hours at (832) 325-7288.

If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.

Located within the Texas Medical Center, The Fetal Center is affiliated with McGovern Medical School at UTHealth Houston, UT Physicians and Children’s Memorial Hermann Hospital.

The Fetal Center Outcomes Data
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