Home Diseases and Conditions Twin Twin Transfusion Syndrome 

Twin Twin Transfusion Syndrome 

Last Updated:
Development Stage

Early Stage

Focused ultrasound research is in the laboratory phase and is not yet available for patients.

Clinical Trials

Focused ultrasound for this condition is being researched in clinical trials.

International Approval

Focused ultrasound is approved to treat this condition outside the US. Patients can seek commercial treatment at participating international sites.

FDA Approved

The US Food and Drug Administration has approved focus ultrasound for this condition. Patients can seek commercial treatment at participating sites.

Early Stage

Clinical Trials

International

FDA Approved

Focused ultrasound for this condition has been researched in clinical trials. However, at this time, we are not aware of any open clinical trials.

Focused Ultrasound Therapy 

Focused ultrasound is a rapidly evolving, therapeutic technology that could transform the quality of life and decrease the cost of care for patients with twin twin transfusion syndrome. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. 

How it Works 

Where the beams converge, focused ultrasound produces a therapeutic vascular occlusion of the larger placental vessels to one of the twins to try to balance the perfusion between the two twins. This treatment has been accomplished in a small number of patients, and publication of the results is expected soon. 

The primary options for treatment of twin twin transfusion syndrome are very limited, and if left untreated, can result in damage to both of the twins. Some situations offer a decision to sacrifice one of the twins to enable the other one to survive.  

For certain patients, a non-invasive alternative is a welcome option for patients that have twin twin transfusion syndrome.  

Advantages 

  • Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.  
  • Focused ultrasound can reach the desired target without damaging surrounding tissue. 
  • It can be repeated, if necessary. 

Clinical Trials 

At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of twin twin transfusion syndrome.  

The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here, it will take you to the latest information available from https://www.clinicaltrials.gov/.  

Regulatory Approval and Reimbursement  

Focused ultrasound treatment for twin twin transfusion syndrome is not yet approved by regulatory bodies or covered by medical insurance companies.  

See here for a list of clinical trials sites 

Notable Papers 

Carlucci S, Lees C, Miloro P, Papastefanou I, Ter Haar G, Dall’Asta A. Doppler ultrasound and first trimester pregnancy: not always a happy marriage. Hum Reprod. 2024 Aug 24:deae176. doi: 10.1093/humrep/deae176. Epub ahead of print. PMID:39180766. 

Expert Rev Hematol. 2020 Mar;13(3):259-267. Twin-twin transfusion syndrome in the era of fetoscopic laser surgery: antenatal management, neonatal outcome and beyond. doi: 10.1080/17474086.2020.1720643. Epub 2020 Jan 31. PMID: 31971028

Janwadkar R, Leblang S, Ghanouni P, Brenner J, Ragheb J, Hennekens CH, Kim A, Sharma K. Focused Ultrasound for Pediatric Diseases. Pediatrics. 2022 Mar 1;149(3):e2021052714. doi: 10.1542/peds.2021-052714. PMID: 35229123 

Salvesen K, Abramowicz J, Ter Haar G, Miloro P, Sinkovskaya E, Dall’Asta A, Maršál K, Lees C Board of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). ISUOG statement on the safe use of Doppler for fetal ultrasound examination in the first 13 + 6 weeks of pregnancy (updated). Ultrasound Obstet Gynecol. 2021 Jun;57(6):1020. doi: 10.1002/uog.23610. PMID: 34077607. 

Smith SF, Miloro P, Axell R, Ter Haar G, Lees C. In vitro characterisation of ultrasound-induced heating effects in the mother and fetus: A clinical perspective. Ultrasound. 2021 May;29(2):73-82. doi: 10.1177/1742271X20953197. Epub 2020 Sep 14. PMID:33995553; PMCID: PMC8083135. 

Spruijt MS, Lopriore E, J Steggerda S, Slaghekke F, Van Klink JMM. Twin-twin transfusion syndrome in the era of fetoscopic laser surgery: antenatal management, neonatal outcome and beyond. 

Shaw CJ, Rivens I, Civale J, Botting KJ, Allison BJ, Brain KL, Niu Y, Ter Haar G, Giussani DA, Lees CC. Maternal and fetal cardiometabolic recovery following ultrasound-guided high-intensity focused ultrasound placental vascular occlusion. J R Soc Interface. 2019 May 31;16(154):20190013. doi: 10.1098/rsif.2019.0013. PMID: 31039691 

Shaw CJ, Civale J, Botting KJ, Niu Y, Ter Haar G, Rivens I, Giussani DA, Lees CC. Noninvasive high-intensity focused ultrasound treatment of twin-twin transfusion syndrome: A preliminary in vivo study. Sci Transl Med. 2016 Jul 13;8(347):347ra95. doi: 10.1126/scitranslmed.aaf2135. PMID: 27412787  

Click here for additional references from PubMed.