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Twin-to-Twin Transfusion Syndrome: A Case Study

Giconi, Stephanie S. MSN, RN, NNP-BC

Section Editor(s): Heaberlin, Pamela

doi: 10.1097/ANC.0b013e31827f058c
Case of the Month

Twin-to-twin transfusion syndrome (TTTS) is a disease that affects roughly 15% of monochorionic twins. Although TTTS is not extremely prevalent, the rate of mortality and morbidly approaches 100% without early detection and treatment. The following case study is a triplet pregnancy that included a set of monochorionic twins affected by TTTS. Typically, it is assumed that monochorionicity can identify the zygosity of twins, which was disproven in this case. Research indicates that there has been an increased rate of monochorionic twins with in vitro fertilization. There is great debate about the most appropriate treatment modality for TTTS. Perinatal treatment followed by neonatal management is the standard of care for TTTS. Implications for the neonatal nurse practitioner and care for the patients are discussed.

Pediatrix Medical Group of Colorado, Memorial Hospital, Colorado Springs, Pueblo West.

Correspondence: Stephanie S. Giconi, MSN, RN, NNP-BC, Pediatrix Medical Group of Colorado, Memorial Hospital, Colorado Springs, 1759 N Heron Dr, Pueblo West, CO 81007 (

The author declares no conflict of interest.

© 2013 National Association of Neonatal Nurses