Because of polyhydramnious, the uterus is enlarged beyond what it would be for the current gestational week for multiples. The mother is at increased risk for pre-term labor beyond what a mother with multiples would ordinarily experience. Upright positioning adds pressure on the cervix and should be avoided. Checking the cervix and putting in a cerclage has helped save as much as 25% of TTTS babies because of the weakened cervix. It is crucial for the cervix to be checked every visit by ultrasound. Having the mother lay on her left side, on the couch, in bed, in a recliner, outside on a lawn chair, on the floor with her kids, helps reduce pressure to the cervix and prevent pre-term delivery.

Dr. Julian De Lia, who pioneered laser surgery, has reported the value of nutritional supplements for women diagnosed with a monochorionic placenta and those with TTTS (his article is enclosed at the end of this section.) He recommends that his patients drink three Boost or Ensure High Protein a day. Dr. De Lia explains, "TTTS patients at mid-pregnancy have severe hypoproteinemia and anemia. These maternal metabolic parameters may influence fetal TTTS characteristics and explain maternal sensitivity to intravenous fluid in complicated multiple pregnancies in general. We believe our data sufficient to support the aggressive use of nutritional supplements in the management of early (monochorionic twins with subtle growth and amniotic fluid differences) and severe TTTS regardless of specific invasive therapy used (i.e., fetoscopic placental laser surgery, reduction amnioncentesis, septostomy, etc.)."

Medical Article

We have seen nutritional therapy and rest help many women. Not only do they begin to feel better, not being malnourished anymore, but also in some, the signs of the TTTS go away! Nutritional therapy has helped avoid laser surgery or other treatments. Mothers also feel immediate relief that there is something they can do right away to help their babies.

Based on our contact with thousands of TTTS pregnancies and the research being done by Dr. De Lia and his staff at the International Institute for the Treatment of TTTS, this is extremely important information. REMEMBER: nutritional therapy, horizontal bed rest, and weekly cervix checks by ultrasounds and cerclages when necessary.