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In a new installment of the Healthful Woman podcast, titled Lauren’s Story, Part 1: Twin to Twin Transfusion Syndrome (TTTS), Dr. Nathan Fox discusses twin pregnancy experiences with Lauren Burnstein. She discusses her diagnosis of stage 2 twin-to-twin transfusion syndrome. She also talks about the surgery needed to fix the problem.

Laurens First Pregnancy

Lauren welcomed her first daughter, Liana, in May 2022. Her first pregnancy went smoothly. She gave birth the day before her due date without any problems. Liana weighed 7 pounds and 14 ounces at birth. Lauren remained active throughout her pregnancy, completing a 5K just ten days before giving birth. When Liana turned one, Lauren and her husband began trying for a second child and learned they were expecting again in July 2023, when Liana was 13 months old.

Lauren’s Second Pregnancy

At her first ultrasound, Lauren was six and a half weeks pregnant. She recalled her OB-GYN saying, “Well, I have some news. I see multiple embryos,” to which she responded with surprise. Lauren attended this appointment alone and was further informed, “I see two embryos. I see one placenta, but I don’t see a dividing membrane between the two,” which initially suggested a higher-risk pregnancy.

A follow-up ultrasound two weeks later confirmed the presence of a dividing membrane. It was also determined early on that the twins were identical and shared a single placenta.

Lauren’s Diagnosis of TTTS

At 18.5 weeks pregnant with twins, Lauren had an ultrasound at Englewood Hospital, where doctors noticed an imbalance in amniotic fluid between her twins, an early warning sign of twin-to-twin transfusion syndrome (TTTS). Although the babies appeared healthy, her provider recommended a consultation at the Children’s Hospital of Philadelphia (CHOP) due to the risks.

She shared, “Everyone at CHOP and Englewood Hospital, everyone was just so kind to me. And so, they were just there to help me.”

When she felt unusually bloated, a known TTTS symptom, a follow-up scan confirmed Baby B’s fluid was dangerously low at 0.2 cm, while Baby A’s measured 12 cm. While at Englewood Hospital with Dr. Fox, she was diagnosed with Stage 2 TTTS, and surgery was scheduled for the next day.

Lauren expressed, “It really taught me, like, you need that constant monitoring, you know, because it does accelerate very, very quickly. But, yeah, so it was just amazing that I was able to have the surgery just the next day, you know.”

Lauren’s Surgery and Recovery

Lauren’s surgery at CHOP was efficient and successful. After pre-op checks, she said goodbye to her husband at the OR entrance and underwent the procedure under light sedation. During surgery, doctors discovered a dense cluster of five vessels in the shared placenta, more than usual, and used laser energy to cauterize the connections. This technique divided the placenta. It reduced abnormal blood flow between the twins. The goal was to stop the progression of TTTS.

Lauren stayed one night in the hospital and the staff discharged her the next day. Doctors placed her on modified bed rest, instructed her to avoid lifting her toddler, and limited her physical activity. Her care team emphasized rest during the first week to support her recovery and the twins’ stabilization following surgery.

Lauren’s Baby’s Heart Issues

Routine follow-up the next day showed stable vitals, but no immediate fluid change was expected. A week later, scans revealed improved fluid levels, a sign that the TTTS was resolving. However, both twins had mild cardiac concerns, and Baby A showed signs of tachycardia.

Lauren was prescribed medication to support Baby A and referred for additional monitoring. Because of the heart issues, her bed rest was extended, and she continued seeing specialists at CHOP, Mount Sinai with Dr. Fox, and a pediatric cardiologist in Paramus for ongoing care.

Tune in to Part 2

To continue following Lauren’s pregnancy journey, listen to Part 2 of the podcast or read our next blog. If you are currently pregnant, consider reaching out to Maternal Fetal Medicine Specialists in New York by completing our online contact form for expert care and guidance.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!