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My phone camera broke, so this was taken with my webcam. I apologize for the poor-quality image.
Twin-to-twin transfusion syndrome (TTTS) is a rare condition where blood is not evenly distributed between twins during pregnancy. It occurs in monochorionic pregnancies, or when twins share one placenta and the network of blood vessels that supply oxygen and nutrients essential for development in the womb (Johns Hopkins Medicine 2021). TTTS relates to the cardiovascular course objectives, more specifically 40. explain how the heart is regulated, 41. know the path of blood through the heart and circulatory system, and 42. explain the structure and function of the heart. To a lesser extent, the reproductive system is an important course objective for TTTS, specifically 9. know the structure and function of reproductive organs.
In twins with TTTS, one twin is a donor twin and the other is a recipient. The donor twin gives away more blood than it receives, leaving it at risk of malnourishment and organ failure. The donor also experiences decreased urine production and bladder growth, which subsequently leads to a decrease in amniotic fluid. The recipient twin receives too much blood and is at risk of overworking the heart and having other cardiac complications (Johns Hopkins Medicine 2021). It occurs in roughly 10-15% of monochorionic pregnancies and is the largest contributor to pre-viable pregnancy loss in this type of pregnancy (Miller, 2021). Generally, when left untreated there is an 80-90% risk of fetal death when left untreated, but when using fetoscopic laser surgery the survival rates for one twin or both can reach 70-88% and 65% respectively (Simpson, et al, 2019). Fetoscopic laser surgery uses a laser to close the vessels connecting the twins and causing the imbalance (Miller, 2021). As of now, fetoscopic laser surgery remains the gold standard for interventions for TTTS. (Simpson, et al, 2019).
TTTS has a personal connection to me, as my two younger brothers are twins and had TTTS. They were saved due to fetoscopic laser surgery, but still had plenty of other complications at, before, and after birth that were likely connected to TTTS.
Bibliography:
Miller, J. L. (2021, May). Twin to twin transfusion syndrome. Translational pediatrics. https://pmc.ncbi.nlm.nih.gov/articles/PMC8193008/
Twin-to-twin transfusion syndrome (TTTS). Johns Hopkins Medicine. (2021, August 8). https://www.hopkinsmedicine.org/health/conditions-and-diseases/twintotwin-transfusion-syndrome-ttts
Zhao, D. P., Simpson, L. L., Lewi, L., Lopriore, E., Slaghekke, F., Chmait, R. H., Lanna, M. M., Hecher, K., Benirschke, K., Khalil, A., Oepkes, D., Dekoninck, P., Baxi, L. V., Quintero, R. A., Michelfelder, E., Rychik, J., Wohlmuth, C., Yamamoto, M., Berghella, V., … O’Donoghue, K. (2019, January 5). Update on twin-to-twin transfusion syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology. https://www.sciencedirect.com/science/article/abs/pii/S1521693418302426?casa_token=_SYg_PU3HPIAAAAA%3AHSXRSkQlMP1MSpiv5C_JwDR_eKqXBME3HeOQo7FZnNvppHyFt5ATn9U-ZF0lG3f4QzRZbV8EaA
The Twin-to-Twin Transfusion Syndrome (TTTS) was captured in this project,a rare and dangerous disorder called TTTS causes an uneven blood distribution in twins who share a placenta. While the other twin receives too much blood, causing severe cardiac strain, and the donor twin loses too much which can lead to underdevelopment. The goals of our cardiovascular course objectives are related to this, especially when it comes to comprehending the structure, function, and circulation of the heart. We’ve also studied the reproductive system, which is related to TTTS, demonstrating the true interdependence of our body’s systems.
What made this project particularly meaningful was the connection of his twin brothers that experienced TTTS during pregnancy. I liked how he used his own personal connection and experices and the outcome now of his brothers, which he was able to put in his work. Learning about this condition makes me feel more educated on the aspect of how twins have even more complications just as if a baby was by itself in the whomb.
Overall, this project allowed me to connect academic knowledge with personal experience, making the subject matter both intellectually fascinating and emotionally impactful. It’s a reminder of why studying human biology matters and how it can intersect with real-life stories in powerful ways.