Treatments for complications of monochromic pregnancies vary depending on the condition of the babies.
Cord Entanglement
In the case of cord entanglement, physicians may recommend delivery of the twins as soon they are mature enough to survive, which may be as early as 24 weeks. In these cases, your doctor may give you corticosteroid medications to accelerate lung development in your twins so they have a greater chance of surviving outside of the womb. Many cases of cord entanglement need extensive monitoring of the twins in the hospital to help determine the best time to deliver them.
Amniotic Fluid Issues
If excessive amniotic fluid is a concern, your physician may perform an amnioreduction to reduce the amount of amniotic fluid. This procedure will:
- Make you more comfortable
- Reduce the chance of premature labor
- Better equalize the flow of blood between your twins
Your physician may need to repeat this procedure throughout your pregnancy.
TTTS
In the case of TTTS, an increasingly successful approach involves disconnecting part of the blood supply between the twins using a technique called fetoscopic laser ablation of the shared placental vessels, otherwise known as laser ablation.
This procedure is only offered at select treatment centers, like Children’s Wisconsin through the Fetal Concerns Center. In 80-85% of laser surgery procedures, at least one twin survives and both twins survive in 65-70% of cases. The survival rate of both twins with TTTS without laser ablation is 10-20%.
TRAP Sequence
If your doctor has diagnosed TRAP sequence, they may recommend delivery of the healthy twin if your pregnancy is far enough along. In other cases, your doctor may recommend prenatal treatments to stop the extra pumping between the twins. These procedures, performed using highly specialized techniques within the womb, may include radiofrequency ablation. RFA is usually performed between 17 and 24 weeks of pregnancy.
RFA is a procedure performed by our team of experts in the Fetal Concerns Center and at a very limited number of neonatal centers across the country. The procedure uses heat energy to stop the blood flow to the umbilical cord of the underdeveloped twin. RFA has been shown to be extremely successful, with a 90% or higher survival rate for the normal twin when delivered at least 35 weeks into the pregnancy.