Twin to twin transfusion syndrome – A Dad’s view

Author:  Aaron Smith

My introduction to Twin to Twin Transfusion Syndrome (TTTS) was kind of subtle, at first.

Pregnant with MCDA twins

We had just found out Casey was pregnant and had our 12 week scan booked in, excited, nervous, ecstatic….. We had a young assistant conduct the ultrasound, not long on the job, and she was speechless when the image of our girls came into view. Looking back it’s easy to forgive her for her excitement as they were our first twins too, but it’s hard to forget that look that came across her face when she said, ‘Oh, they are MCDA twins’.

I didn’t know what it meant but is sounded bad. So I let loose a flood of questions on the poor girl. ‘What does that mean?’ ‘What do we need to do?’ They are OK, right?’. At this point she deferred all questions until the Sonographer was available.

Turns out it’s nothing to worry about, we had identical twins (cool right!); though they considered the pregnancy ‘high risk’. Just the words Casey needed to hear over and over. So I became Dr Google. The last thing Casey needed was to read about the negative stuff, know about the risks and dangers.So it became my job to learn, what to look out for, what to listen out for when Casey is talking about the bumps and kicks. Being prepared so that if something were to happen I could be the one carries the stress while Casey had the important job of carrying the girls.

About TTTS

TTTS is a serious condition that can develop in identical twins that share the placenta. Simplified, one baby can start to take more than their fair share from the shared source. One baby will become dehydrated as they become the ‘donor’, the other will develop high blood pressure, excessive urine (which over fills the amniotic sac) swelling their little belly and putting pressure on their internal, growing organs. What can you do? Not much. Just continuous scans (every 2 weeks) to check that development of the bubs is even & normal. If the TTTS is slow to progress there is a chance that lasers can be used to burn the blood vessels between the babies and even out the imbalance. But if it’s fast…….

32 weeks pregnant with MCDA twins

On the Wednesday our girls weighed an even and healthy 2.8kgs each. Not bad for 32 week old twins. Casey called me after the ultrasound, super high spirits and sending me photos of our girls. We had already decided that twin 1 was Evie, twin 2 Charli. We were talking natural delivery, water birth and even discussing the soundtrack our little cherubs would be brought into the world to.

I was giving Casey grief as she had just packed her hospital bag, with still 2 months to go!!.

TTTS – the first signs something was wrong

On Sunday they were born at 1.9kg for our little Charli and 3.8kg for Evie. Casey had woken up on Sunday in the best mood she had been in since the 1st trimester. The midnight dance party and follow up 4am soccer game hadn’t kept her up last night.

Alarm bells started ringing in my head but I had to (try to)play it cool. ‘So babe, how are the girls now? Are they up and moving around?’.I’d thought I was a subtle as s summer breeze, turns out it was more like a sledgehammer. I could see in Casey’s face that I had alarmed her too.

For the purposes of the story I’ll say we had a nice little conversation about what we were planning to do that day which might include a drop in visit it the hospital. We disagreed on the day’s itinerary but compromised with ‘breakfast down at Cronulla, if the girls haven’t moved by the end of breakfast we will call the hospital’.

We called and they said drop in, a quick check can’t hurt.

TTTS a dads perspective

TTTS – when things go wrong………….fast

Whether the TTTS triggered the Supraventricular tachycardia(SVT) or vice versa was irrelevant. Evie was in trouble as she was absorbing,at a fast rate, everything that Charli had to give and her little body had trouble containing it.

Her belly, her head…. Swelling and her little heart was pumping out at over 300 bpm. They didn’t even have the right equipment at St George Hospital to measure the heart rate, it was too fast. So they called an ambulance.

Casey’s mum jumped a flight and was heading down. The girls were coming out within the next few hours.

All our planning, pointless, except for the hospital bag.

From a breakfast out with my lady to an ambulance ride for Casey over to the hospital, to our beautiful girls being born. TTTS happens fast.

32 weeks pregnant TTTS
32 weeks pregnant TTTS

TTTS advice from a Dad who has been there

 My advice. Know a little, don’t panic but definitely stay vigilant and trust your gut. Your partner is carrying babies, growing life, inconceivable. All thoughts, feelings and emotions are shared between her and the life she is growing. She doesn’t need to worry about what could happen or the ‘if’s and but’s, but someone needs to.

32 weeks pregnant MCDA twins

Personally, I felt helpless for the majority of the pregnancy, but when I was able to talk to the doctors that day, discuss the situation from an educated, albeit Dr Google, position and take that stress away from Casey, I felt I just had my first Dad Win. If we hadn’t of gone to the hospital that morning when the girls stopped moving….. I’d hate think where we would be today.



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