An illustration of the artery-to-vein connections on the placenta that occur in babies with TTTS and TAPS. Click to enlarge.

Twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are rare, prenatal conditions that affect twin pregnancies where the twins share a placenta (monochorionic or identical twins). TTTS and TAPS occur when blood volume or oxygen is unevenly distributed between the twins and often requires intervention to provide the best chance of survival for both babies.

TTTS and TAPS Treatment: Why Choose Johns Hopkins

• The Johns Hopkins Center for Fetal Therapy understands the urgency of a diagnosis of TTTS and TAPS. We are available to take your call at any time and will see you as soon as possible.
• Using the latest imaging technology, we are able to assess the severity of the condition and diagnose potential pregnancy complications before they arise. We will then work together to determine the best treatment plan for both you and your family.
• For over a decade, our fetal surgeons have performed extensive fetoscopic laser surgeries for the treatment of TTTS and TAPS. We were one of the first to establish the benefits of the Solomon laser technique, which offers the best chance of resolving TTTS and TAPS in a single treatment procedure and can be performed in some of the most complicated cases.
• We also have expertise managing a range of pregnancy complications related to TTTS and TAPS, including pre-term labor or cervical shortening. We closely monitor your pregnancy to ensure the best outcome for both you and your babies.

An illustration of the red blood cell imbalance that occurs in babies with TTTS and TAPS. Click to enlarge.

TTTS and TAPS Treatment: What to Expect

At your first appointment, you will meet with our TTTS and TAPS experts, who will perform a detailed evaluation to determine the severity of the condition. Diagnostic procedures include:

• Detailed fetal ultrasound
• Fetal echocardiogram

We first perform a specialized imaging assessment that provides a more detailed view of the condition than a traditional ultrasound. We then determine the condition’s severity by comparing the results of your ultrasound to the extensive research data on similar ultrasounds we have collected.

Following your initial consultation, we will review your assessment results and your treatment options with you. We will also present our center-specific treatment outcomes and work with you to develop your care plan.

If we determine that surgical treatment is urgently required, we are able to offer minimally invasive fetoscopic laser surgery 24 hours a day, 7 days a week. The goal of surgery is to treat as many aspects of the disease in a single procedure and promote healthy development of both twins throughout the pregnancy.

After surgery, we conduct follow-up exams to identify if additional treatment is required. If it is needed, we make recommendations for your continued care. In most cases, patients are able to return to their referring doctors for their prenatal care and delivery. If you choose to continue care at Johns Hopkins, we will work with you to coordinate your delivery and any necessary postpartum care.

Learn more about TTTS and TAPS treatment before birth.

Our TTTS and TAPS Specialists

Drs. Miller, Baschat, Kush and Rosner of the Johns Hopkins Center for Fetal Therapy.

Rely on the expertise of our physicians to help your family understand and treat TTTS or TAPS.

Fetal Medicine & Surgery

Ahmet Baschat, M.D.
Jena Miller, M.D.
Mara Rosner, M.D., M.P.H.
Michelle Kush, M.D.

Anesthesiology

Jamie Murphy, M.D.

Our Featured Research

Johns Hopkins experts are at the forefront of research into the benefits and proven outcomes of the Solomon laser treatment method for TTTS and TAPS. Our research includes:

• Study detailing outcomes of Solomon laser treatment for twin-to-twin transfusion syndrome
• Study about ultrasound findings after Solomon laser treatment of TTTS