TUCSON, Ariz. (Aug. 8, 2024) – Banner – University Medicine Fetal Care Center performed its first twin-to-twin transfusion syndrome (TTTS) surgery.
TTTS is a pregnancy complication that affects approximately 15% of identical twin pregnancies. The syndrome occurs when identical twin fetuses, which share a placenta, receive unequal blood flow due to abnormal blood vessel connections in the placenta. The unequal blood flow between the two fetuses – one the “donor” and the other the “recipient” – can result in imbalanced levels of oxygen and nutrients that are essential for fetal development.
The donor fetus may receive too little blood, resulting in reduced urine output, decreased urine in the bladder, lower amniotic fluid levels, and potentially a smaller placental share, which can impair growth. The recipient fetus may receive too much blood, putting an extra strain on the heart and increasing the risk for heart failure. The additional blood volume also causes the recipient to produce excess amniotic fluid and excess urine, resulting in an enlarged bladder. The imbalance can cause fetal demise, in which case there is a greater than 40% chance of neurologic injury or death to the remaining fetus.
In this first case for the hospital, the mother presented with significant TTTS complications. The recipient fetus was experiencing heart failure and an accumulation of fluid in the abdominal and chest cavities. Banner’s fetal surgery team used a fetoscope inserted into the uterus through a small incision in the mother’s abdomen to close the twin fetus’ abnormal blood vessel connections and restored equal blood flow.
The mother was hospitalized overnight before being discharged the following day. Subsequent tests have shown a balance of fluid levels between the twins and normal bladder function. Additionally, the recipient’s heart failure has resolved and both twins’ hearts are functioning normally. The twins continue to growth in-utero, currently at 30 weeks gestation. The mother will continue to receive follow-up care at Banner – University Medical Center Tucson until her delivery date in mid-October and beyond, as needed.
Banner’s fetal care center is home to an interdisciplinary team combining the expertise of Banner – University Medical Center Tucson and Banner Children’s at Diamond Children’s Medical Center.
The fetal center is led by Kenneth Liechty, MD, a fetal and pediatric surgeon, director of fetal medicine at Banner – University Medicine, and surgeon-in-chief at Banner Children’s at Diamond Children’s Medical Center. Dr. Liechty has been providing fetal care across the country for more than 15 years and has led the development of the fetal surgery program at Banner – University Medicine.
To learn more about the Banner – University Medicine Fetal Care Center, please visit: https://surgery.arizona.edu/divisions-and-sections/pediatric-surgery/fetal-surgery
About Banner Children’s – Diamond Children’s Medical Center
Banner Children’s – Diamond Children’s Medical Center provides pediatric care for children, from newborns to teens. Services include emergency care, heart disorders, traumatic brain injury, autism and developmental disorders, cancer, diabetes and endocrinology, gastrointestinal and nutritional disorders, neurological problems, orthopedics, intensive care needs and more. It is the only pediatric medical facility in Arizona connected to an academic research facility — the University of Arizona Steele Children’s Research Center — where physician-scientists provide access to groundbreaking science and research to advance children’s health. For more information, visit bannerhealth.com/diamondchildrens
About Banner – University Medical Center Tucson and South
Banner – University Medical Center Tucson and Banner – University Medical Center South are part of Banner – University Medicine, a premier academic medical network. These institutions are academic medical centers for the University of Arizona College of Medicine – Tucson. Included on the two campuses are Diamond Children's Medical Center and many specialty clinics. The two academic medical centers are part of Arizona-based Banner Health, one of the largest nonprofit health care systems in the country. Banner Health is in six states: Arizona, California, Colorado, Nebraska, Nevada and Wyoming. For more information, visit bannerhealth.com/universitytucson or bannerhealth.com/universitysouth.
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