MedlinePlus Medical Encyclopedia: Fetal transfusion syndrome

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Fetal transfusion syndrome

Contents of this page:
Alternative names Definition Causes, incidence, and risk factors Symptoms	Signs and tests Treatment Expectations (prognosis) Calling your health care provider

Alternative names

Twin-to-twin transfusion

Definition Return to top

Fetal transfusion syndrome is a rare condition that occurs only in identical twins. It involves the transference of blood from one fetus directly to the other in the womb.

Causes, incidence, and risk factors Return to top

In fetal transfusion syndrome, the donor twin is usually born smaller, anemic, and dehydrated while the recipient twin is born larger and polycythemic, with too much blood volume and increased blood pressure.

Both infants may have problems depending on the severity of the transfusion -- one from an inadequate blood volume, and the other from too much blood. The donor twin may need a blood transfusion, while the recipient twin may need blood volume reduction.

Because of the increased blood volume, the recipient twin may develop cardiac failure and also require medications to strengthen heart function.

Symptoms Return to top

Unequal size of identical twins (discordant twins)
Pallor (paleness) in the smaller twin and plethora (redness) in the larger twin

Signs and tests Return to top

Both of the twins will receive the following tests:

CBC to check hematocrit
Chem-20 to evaluate electrolytes
PT and PTT (clotting studies)
Chest x-ray

Treatment Return to top

The goal of treatment is to treat each child's problem. The donor twin may be anemic enough to need a blood transfusion. The recipient twin may need to have the volume of fluid reduced (this may involve a exchange transfusion).

Medications, such as furosemide (Lasix), and, rarely, digitalis (digoxin), may be used as supportive treatment. A digoxin level may be tested at regular intervals if this medication is needed to treat heart failure in the recipient twin.

Expectations (prognosis) Return to top

If the twin-to-twin transfusion is mild, full recovery is expected for both babies. However, severe cases may result in the death of a twin.

Calling your health care provider Return to top

This condition is usually diagnosed at or shortly before the time of birth.

Update Date: 7/15/2004

Updated by: John Goldenring, M.D., MPH, Department of Pediatrics, Children's Hospital, San Diego, CA. Review provided by VeriMed Healthcare Network.

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