• Multiple Births Canada

A TTTS Story: Surgery to Save Our Boys

Updated: Apr 29


My husband and I first found out we were expecting identical twins at 8 weeks along. At 13 weeks we had our first MFM appointment. At that time we were well informed about the possible challenges we could face throughout our MoDi twin pregnancy, Twin to Twin Transfusion Syndrom being the main challenge. Our doctor told us that TTTS is rare and only occurs in about 5-15 percent of identical twin pregnancies, so of course we thought it wouldn't affect us.


At 16.5 weeks we were so excited to find out that our identical twins were boys! Unfortunatly, the ultrasound techs and the amazing MFM doctors at our local childrens hospital (IWK Halifax) told us not to celebrate too much as there were also signs of the beginning stages of TTTS. Baby A's (Keegan) sac was quite full of fluid where baby B's (Bryce) sac was minimal and his bladder was barely visible. This meant that there were vessels connecting both babies and baby B (Bryce) was giving all of his nutrients to baby A (Keegan.) When this occurs both babies are equally affected. The baby who's sac is filled with fluid has a lot of strain put on their heart where the other baby is basically shrink wrapped in their sac and their bladder does not function properly. We were told that we were quickly approaching stage 1 but luckily not quite there yet. Our MFM informed us that normally surgery does not happen until stage 2 but he had a gut feeling that the TTTS was going to progress quickly. He made contact with the closest hospital to perform TTTS laser surgery (Mount Sinai in Toronto) and explained our situation.


Within a few days my husband and I were on our way to Toronto for surgery to save our boys. When we arrived an exam was completed and it was confirmed that the TTTS had already reached stage 2. We were then informed of the risks involved with and without the surgery as well as survival rates. If after the surgery was performed and preterm labor started there would be nothing the doctors could do to save them. There may also be a chance that something could go wrong during surgery or vessels were still going to be connected and the TTTS could return. The survival rate with the surgery is very high, However not going through with the surgery meant our boys would only have a 10-15 percent chance of surviving. The choice was a no brainer for us, do all that we could and go through with the surgery.


The doctors thoroughly explained the procedure to us. Mild sedation would be used and they would make a small incision under my belly button and into my uterus. They would go in with a microscopic laser and a camera to seperate the connecting vessels.


Within 24 hours we were undergoing the laser surgery. Although highly medicated my husband and I distinctly remember seeing baby A (Keegan) on camera floating around in his sac while the doctors were performing the surgery. All of the blood vessels in his body were visible and he was transparent. Although traumatic and stressful the experience was also amazing and unforgettable, something we will never forget!

The surgery was successful and we made it 32.3 weeks pregnant, but of course not without some further challenges. Baby A's (Keegan) water broke and diagnosed with pre rupture of membranes at 29 weeks. Labor was stopped and put on hospital bed rest for the remainder of the pregnancy. Baby A (Keegan) was born with a weight of 4.1 and some lung issues, Baby B (Bryce) was born with a weight of 3.4 and no health issues. We spent a total of 49 days in the NICU.


Shared by: Candace Fiander and Bradley Fiander.


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