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>> THAT DAY IN THE ULTRASOUND ROOM WHEN
THAT TECHNICIAN LOOKED AT US LIKE YOU TWO KNOW YOU'RE
HAVING TWINS.
>> ON ULTRASOUND YOU COULD SEE A LOT OF DETAIL BECAUSE
IT WAS A LEVEL TWO ULTRASOUND.
>> IT'S VERY UNCOMMON.
ONLY 10, 15% OF MONOCHORIONIC TWINS DEVELOP THIS TYPE
OF A SYNDROME.
>> YOU COULD TELL THEY WERE BOTH GIRLS.
>> AND FOR ONE MOMENT IT WAS EXCITING.
>> WE STILL DON'T KNOW THE EXACT REASON BEHIND WHY
CERTAIN MONOCHORIONIC PREGNANCIES ARE AFFECTED
BY TWIN-TO-TWIN TRANSFUSION SYNDROME.
>> I COULD SEE THE SCREEN THAT SOMETHING WAS WRONG.
THERE WASN'T ANY FLUID IN THE ONE SAC AT ALL.
>> IT RESULTS FROM AN IMBALANCE IN THE FLOW
BETWEEN SPECIFIC BLOOD VESSELS THAT ARE IN
THE PLACENTA OF MONOCHORIONIC PREGNANCIES.
>> THEY DON'T SHARE THE PLACENTA EQUALLY.
>> THAT DOCTOR CAME IN, TOOK A LOOK AT THESE ULTRASOUNDS.
>> HE DIDN'T SAY A WORD.
HE JUST WAS LOOKING AND KIND OF TAKING NOTES.
AND THEN HE BROUGHT US INTO HIS OFFICE AND SHUT THE DOOR
AND HE SAID, "THIS IS GOING TO BE A VERY
DIFFICULT PREGNANCY."
>> TWIN-TWIN TRANSFUSION SYNDROME
IS A COMPLICATED DISORDER.
>> THE SERIOUS COMPLICATION OF MONOCHORIONIC
OR IDENTICAL TWIN PREGNANCIES.
>> MONOCHORIONIC MEANING THAT THEY SHARE A PLACENTA.
>> IN A MONOCHORIONIC DIAMNIOTIC PREGNANCY THERE
IS ONE CHORION, WHICH IS THE OUTER SAC,
AND EACH TWIN IS IN ITS OWN AMNION SO THAT IT'S LIKE
A SINGLE BALLOON WITH TWO FILLED BALLOONS INSIDE IT.
>> ONE TWIN, THE RECIPIENT TWIN,
GETS TOO MUCH BLOOD.
AND THE OTHER TWIN, THE DONOR TWIN,
DOESN'T GET ENOUGH BLOOD.
>> BECAUSE THE AMOUNT OF OXYGEN AND NUTRITION GOING
TO THE DONOR BABY IS LESS THAN TO THE RECIPIENT BABY,
THEY GROW AT DIFFERENT RATES.
>> ONE TWIN WILL END UP BEING VERY LARGE,
HAVING EXCESSIVE AMNIOTIC FLUID AROUND IT
OR POLYHYDRAMNIOS.
>> THE OPPOSITE KIND OF OCCURS IN THE SMALLER BABY,
OR THE DONOR BABY.
>> THEY OTHER TWIN ON ULTRASOUND WILL SHOW ITSELF
AS BEING VERY SMALL FOR GESTATIONAL AGE.
IT WILL HAVE DECREASED AMNIOTIC FLUID OR ACTUALLY
NO FLUID.
>> OVER TIME THE AMNIOTIC FLUID AROUND THE DONOR BABY
SHRINKS AWAY UNTIL LITERALLY THE BABY BECOMES SHRINK
WRAPPED ALONG THE SIDE OF THE UTERINE WALL
OR PLACENTA.
>> AS THIS DISEASE PROGRESSES YOU END UP SEEING
CARDIAC CHANGES IN BOTH OF THE BABIES.
>> WHEN WE BEGIN TO SEE CARDIAC CHANGES ONE CAN HAVE
SIGNIFICANT COMPLICATIONS AS A CONSEQUENCE,
WHICH CAN LEAD TO EITHER RESIDUAL ISSUES THAT THESE
FETUSES FACE OR EVEN DEATH IN EITHER THE RECIPIENT
OR THE DONOR.