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Of all the questions that
concern TTTS couples, this seems to be the most important
so the answer will be the most comprehensive. The treatments
for TTTS pregnancies depend, in part, on when in pregnancy
the twins become affected. If the twins are mature enough
to survive outside the womb (beyond 25 weeks), immediate delivery
is an option for TTTS babies. However, the doctors must weigh
the health effects of the prematurity on the twins versus
the continued effects of the TTTS abnormalities as they try
to prevent any handicaps in the survivors.
The Foundation continuously reviews the latest medical scientific
reports (see section on Medical Research and Articles) to
determine for TTTS couples which treatments appear to lead
to the highest survival rates for the babies, the highest
number of healthy survivors, and the lowest rates of prematurity
for the twins. The Foundation also recognizes that it is impossible
to save all TTTS twins and completely eliminate the risk of
handicap in survivors regardless of treatment because of the
nature of the placental abnormalities in TTTS.
The different treatments for TTTS can be classified into those
that address the connecting blood vessels in the monochorionic
(shared) placenta, those that treat the symptoms, and, sadly,
those that reflect a sense of hopelessness on the part of
the doctors. We know that none of the treatments have been
evaluated in what doctors call ‘randomized studies’
or ‘comparative trials.’ A randomized trial means
taking a group of TTTS cases and only treating half, then
comparing the outcomes in the treated patients to the untreated
patients. Such studies may be reasonable in other diseases,
but the well documented, historic TTTS death and morbidity
(damage) rates calls into question the ethics of such studies.
The Foundation does not support this type of experiment for
TTTS parents. A comparative trial takes TTTS cases and treats
them with one of two or more available therapies to see which
has the best outcomes. Well planned and designed comparative
trials are also rare.
Regardless of therapy directed at the babies or placenta,
the Foundation recommends monitoring the mom's cervix and
nutritional supplements in ALL cases.
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Sophie and
Sara
I underwent the laser surgery on August
14th, 2002, at only 18 1/2 weeks of pregnancy. In the operating
room, Dr. De Lia keeps prayer cards of Saints Gerard and Jude, the
patron Saints of pregnancy and hopeless causes. Just before the
surgery, we said a prayer together and asked St. Gerard to help
our babies stay strong. I drifted off under the anesthesia, knowing
that I was in the hands of a faith-filled surgeon who is totally
dedicated to saving little twin babies with TTTS.
On December 15th, 2002, over eighteen weeks
after their in-utero surgery, our beautiful little angels Sophie
and Sara were born
Katie , Mother of Sophie
of Sara |
