The benefits of best rest (or lying on a couch or the floor) in multiple gestation has always been debated by doctors. However, TTTS is a high-risk complication in which all possible beneficial remedies should be utilized to improve outcomes. Horizontal rest should be used.

Horizontal rest (on your side) will help your blood flow and oxygen to your womb, and aid in removing some of the excess edema fluid in your body.

Work is problematic for many women affected by TTTS. Studies have shown a definite relationship of physically demanding work to adverse outcome in pregnancy. Given the high-risk nature of a TTTS multiple pregnancy, we recommend a leave of absence for the duration, especially if you are undergoing one of the treatments outlined above.

Horizontal rest may also aid in preventing or treatment of cervical shortening in TTTS patients.