Moms can prevent deadly threat to identical twins

AUSTIN (KXAN) — Doctors are learning more and more about a condition that could threaten the lives of your as-yet unborn identical twin babies. It is TTTS, or twin to twin transfusion syndrome, and it must be caught quickly for the children to survive. But there is something pregnant moms can do.

Dr. David Reue, an OBGYN with Seton Medical says, “Before we had a good treatment for it the majority of pregnancies that developed twin to twin transfusion didn’t survive and that usually happens in the second trimester.” About 15% of identical twins share the same placenta but receive uneven blood from the mother, one child too little, the other too much. If not caught, they won’t survive. A mom carrying identical twins must step up the frequency of her ultrasounds, getting one every one to two weeks. Dr. Reue explains, “It can come on in a matter of a week or two. So when you do the ultrasound the main thing you’re looking for is the fluid volume around each baby.”

Kimberly Rivera, an identical twin herself, was carrying Olivia and Layla when the symptoms came on earlier this year, in her second trimester. She says, “I became large really quickly, my uterus grew, I had a lot of abdominal discomfort, a lot of swelling and I honestly thought that was just because I was carrying twins. When I look back at the twin transfusion syndrome they actually match my symptoms to a tee and had I known that, I would have been better prepared for the diagnosis of the syndrome.”

In addition to her OBGYN, Kimberly also consulted an MFM, a maternal fetal medicine specialist, a vital step if you’re carrying twins. Even so, she wasn’t prepared for the bad news. Dr. Reue says, “About 70% didn’t survive. Now the survival rate is much better. With treatment the chance of at least one baby surviving is 90% and the chance of both babies surviving is 60%.” When she learned, Kimberly says, “That was pretty devastating. The option was we’d have to go to Houston for the surgery or we’d lose both babies within the next two weeks in utero. So you feel completely helpless.”

Kimberly had the laser procedure in Houston, the babies’ blood supply evened up, and despite odds not much better than fifty-fifty, both her children made it. Asked if she can imagine having only one of them with her now, she replies, “I couldn’t imagine it. I’m an identical twin, I went through life with my twin and so just to have one of them would have been really heartbreaking for us.”

While on the subject of pregnancies, a warning about this flu season. Many pregnant women choose not to get the flu vaccine for fear it may have ramifications for the child they are carrying. But doctors say pregnant women are at the highest risk for getting the flu, and getting seriously ill. The vaccine for them may be more important than for anyone. Dr. Reue says, “A lot of pregnant women are understandably hesitant about the vaccine, they don’t want to harm the baby but they need the flu shot the most. When you’re pregnant your immune system does not work as well, pregnant women are most likely to get the flu if they’re exposed to it and pregnant women can get much sicker with the flu than someone who is not pregnant.” And remember, the vaccine takes two weeks to build up the antibodies that fight the flu virus so there is not time to waste.

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