Obstetrics and Prenatal Medicine, UKE Hamburg, Germany

UKE is leading university teaching hospital in Germany and Department of Obstetrics and Prenatal Medicine is one of only a few centres in Europe to offer laser treatment for Twin to Twin Transfusion Syndrome (TTTS)

Twin to Twin transfusion syndrome (TTTS) is a disease of the placenta. It develops in identical twins during pregnancy because of the presence of connecting blood vessels between the two umbilical cords. There is repeated transfusion of small amounts of blood between the two twins through these vascular connections.

Laser therapy for TTTS

The receiving foetus (the recipient) has too much blood volume, which can result in heart failure and death in the womb. The transfusing twin (the donor) has too little blood volume and may die due to malnutrition.

What is Twin to Twin Transfusion Syndrome?

The recipient produces excessive amounts of urine which leads to an increase in amniotic fluid volume. This may cause discomfort to the mother and also results in pressure on the cervix, which is the lower part of the womb.

With continuing pressure the cervix may open resulting in miscarriage or preterm delivery. The donor twin hardly produces any urine and therefore has almost no amniotic fluid in his sac.

In Twin to Twin transfusion syndrome the twins themselves are completely normal in most of the cases. The problem lies in the placenta which then results in disturbed development in the twins.

For further details visit the Obstetrics page.

UKE is one of only a few centres in Europe to offer laser therapy to treat the underlying cause of TTTS before amnioreduction is performed, resulting in a significantly higher chance of subsequent normal development for the twins.

With an anterior placenta (on the near wall) of the uterus or following amnioreduction the procedure may be technically more difficult and UKE uses a special form of fetoscope which was specifically designed for this purpose.

The chance for survival of both twins is 70% and that for survival of at least one twin about 90%. The increased risk for significant neurological damage in surviving babies remains, but appears to be lower than the risk following serial amnioreduction (6% for severe and 7% for mild neurologic abnormalities).

The UKE Obstetrics team

Prof Kurt Hecher

Prof Bernd Hüneke

Prof Thierry Somville

Mr Werner Diehl

Mr Peter Glosemeyer

Dr Manuela Lotz

Mr Gerd Ortmeyer

Dr Bettina Hollwitz

Heike Molter
Head of Midwifery

Veronique Charpentier
Nurse, prenatal

Ulrike Attmer
Nurse, postnatal

Downloads

Download the UKE Guide to Twin to Twin Transfusion Syndrome

Other specialities

The centre offers a full range of fetal diagnostic and therapeutic services including:

Prof. Kurt Hecher, Chairman of the Department, is one of the pioneers of fetoscopic ablation of vascular anastomoses in twin to twin transfusion syndrome. The team has extensive experience with the counselling, pre-procedure assessment and management of complicated monochorionic gestations

Prof Kurt Hecher

Intrauterine surgical procedures such as cord coagulation and other techniques

Comprehensive non-invasive and invasive evaluation of pregnancies at risk for fetal anaemia and an active transfusion programme.

Evaluation and management strategies for placental dysfunction. The team has extensive experience with the management of fetal growth-restrictive disorders.

Prenatal counselling and first trimester diagnosis in affiliation with the Department of Human Genetics.

The unit is certified through the Fetal Medicine Foundation in the application of first trimester nuchal translucency scanning and risk analysis

For information on the University Medical Centre, Hamburg-Eppendorf, visit the UKE page.

Specialist treatments < Obstetrics < Obstetrics centres < UKE Obstetrics

Universitätsklinikum Hamburg-Eppendorf (UKE)

University Medical Centre, Hamburg, Germany

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Obstetrics and Prenatal Medicine

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