Warning signs in the mother include:

The sensation of a rapid growth of the womb
A uterus that measures large for dates
Abdominal pain or tightness, or uterine contractions
Sudden increases in body weight
Hand and leg swelling in early pregnancy


Warning signs in the twins appear on ultrasound scans and include:

Evidence of a monochorionic or shared placenta
A single placenta
Same sex twins
A thin, hard to see, dividing membrane

Evidence of TTTS

Polyhydramnios (excess amniotic fluid) in the sac of one twin
Oligohydramnios (decreased to no amniotic fluid) in the sac of the other twin
Size differences (discordance) in the twins
Hydrops fetalis (water in one baby's body from heart failure)



It is crucial for parents with a multiple gestation to determine their placental type early. With monochorionic twins, you should watch carefully for the warning signs listed above. Since TTTS is a high-risk problem that can happen quickly and at any time in pregnancy, frequent examinations and ultrasound scans are necessary to catch the problem early. It is critical that physicians be aware of the warning signs. THE FOUNDATION ADVOCATES WEEKLY ULTRASOUNDS WITH A PERINATOLGIST FROM 16 WEEKS GESTATION THROUGH DELIVERY TO LOOK FOR PLACENTAL SHARE PROBLEMS AND TTTS.