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.
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.
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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.
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.
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