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Acute intrapartum twin to twin transfusion syndrome – a large tertiary referral cohort and review of four cases
  1. E Ciantar,
  2. K Cohen,
  3. M Rathod,
  4. E Ferriman
  1. Leeds General Infirmary, Leeds, UK


Objective To determine the incidence of acute intrapartum twin to twin transfusion syndrome (TTTS) in monochorionic twins.

Methods Retrospective review of 451 multiple pregnancies booked into a dedicated multiples clinic at Leeds General Infirmary between 2004 and 2009.

Antenatal TTTS made according to Quintero's criteria.1 Acute intrapartum TTTS diagnosed by the presence of discrepant birthweight and neonatal haemoglobin levels.

Results There were 88 sets of monochorionic twins during this period, with 19 cases of TTTS (19/88, 21.6%).

Four cases occurred for the first time intrapartum. Three occurred in normally grown monochorionic pregnancies, and one case was previously discordant for growth only.

Intrapartum TTTS.

Mean birthweight discrepancy 480 g (290–780 g).

Mean difference in donor-recipient haemoglobin estimation 10.5g (range 8.2–16.1 g).

Conclusion Acute intrapartum TTTS is uncommon but can occur in uneventful monochorionic pregnancies. Prompt recognition is important to reduce neonatal morbidity.

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