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Twin-to-Twin Transfusion Syndrome and Twin Anemia Polycythemia Sequence Treatment

Illustration of TTTS and TAPSThe artery-to-vein connections on the placenta that occur in babies with TTTS and TAPS.

TTTS and TAPS are two possible complications of monochorionic (identical twin) pregnancies. In TTTS, there is an imbalance of the fluid components of blood between the babies. This causes signs of excess hydration in the twin that receives increased fluid volume (recipient) and signs of dehydration in the donor twin. In TAPS, there is an imbalance of the red blood cells between the babies. The recipient twin has more red blood cells, producing thick blood (polycythemia), whereas the donor twin has a low blood count (anemia).

Both conditions are caused by artery-to-vein connections on the placenta that allow transfusion of blood volume or red blood cells from the donor twin to the recipient twin. If untreated, TTTS and TAPS place both twins at risk of serious complications.

Fetoscopic Laser Ablation Surgical Footage

Dr. Ahmet Baschat, director of the Center for Fetal Therapy, presents footage from a minimally invasive in utero surgical procedure that can correct twin-to-twin transfusion syndrome and twin anemia polycythemia sequence.


TTTS and TAPS: What You Need to Know

Graphic of blood imbalance in TAPS and TTTSThe red blood cell imbalance that occurs in babies with TTTS and TAPS.
  • We understand the urgency involved with treating twins with a diagnosis of TTTS or TAPS. The Center for Fetal Therapy is available to take your call at any time and will see you as soon as possible.
  • Our team represents one of the most experienced centers in the United States for performing fetoscopic laser surgeries and treating complicated monochorionic twin pregnancies.
  • The majority of fetoscopic laser surgeries performed by our team will result in the survival of both twins.
  • After treatment for TTTS or TAPS, our patients will have continued access to the most advanced care specialties at Johns Hopkins, including advanced brain imaging, pediatric cardiology and developmental follow-up, if necessary.
  • Following laser surgery, most patients can continue care with their referring practices.

Our Physicians

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

Photo of Dr. Ahmet Alexander Baschat, M.D.

Baschat, Ahmet Alexander, M.D.

Professor of Gynecology and Obstetrics
Joint Appointment in Surgery
Director, Center for Fetal Therapy
Photo of Dr. Jena Lyn Miller, M.D.

Miller, Jena Lyn, M.D.

Assistant Professor of Gynecology and Obstetrics
Assistant Professor of Surgery
Photo of Dr. Jamie Deneen Murphy, M.D.

Murphy, Jamie Deneen, M.D.

Associate Professor of Anesthesiology and Critical Care Medicine
Associate Professor of Gynecology and Obstetrics
Director of Obstetric Anesthesia
Photo of Dr. Mara Rosner, M.D., M.P.H.

Rosner, Mara, M.D., M.P.H.

Assistant Professor of Gynecology and Obstetrics
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