New minimally invasive laser treatment saves the lives of twins with TTTS

NewYork-Presbyterian Morgan Stanley Children's HospitalNov 13 2009

As the number of women having twins has increased, so has the odds of developing a serious pregnancy complication called twin-to-twin transfusion syndrome (TTTS). This disorder affects as many as 15 percent of identical twin pregnancies, and results in uneven blood flow between the fetuses. Until recently the outcome was usually death or disabilities for the surviving babies.

Now a new minimally invasive laser treatment has improved the odds. Available at NewYork-Presbyterian Morgan Stanley Children's Hospital -- one of only 10 centers to offer it, and the only one in New York -- the procedure involves coagulating unnecessary and harmful blood connections between the two fetuses.

"This laser treatment has saved the lives of many twins with TTTS, giving them the chance to grow up healthy and strong," says Dr. Lynn Simpson, medical director of the Center for Prenatal Pediatrics at NewYork-Presbyterian Morgan Stanley Children's Hospital and associate professor of clinical obstetrics and gynecology at Columbia University College of Physicians and Surgeons. "The laser approach is straightforward and safe. And while it isn't always successful, it is a major improvement over the traditional approach of draining the mother's amniotic fluid."

Studies show that in about 90 percent of laser cases, one twin will survive, and in 70 percent of cases, both will. The traditional approach has a survival rate of only 66 percent for a single fetus. Normal brain development is also more likely in babies treated with the laser procedure.

Since Morgan Stanley Children's Hospital began offering laser treatment in July, all TTTS cases meeting criteria for coagulation therapy have been treated using the laser.

The hour-long procedure is performed under local or regional anesthesia and uses a tiny scope that carries the laser wire and a camera though the mother's abdomen and into her uterus. While it can be done on an outpatient basis, mothers are usually kept overnight for observation.