TTTS is thought to arise from an intertwin transfusion imbalance across the vascular anastomoses with hypervolemia, polyuria and polyhydramnios in the recipient and hypovolemia, oliguria and oligoanhydramnios
in the donor. However, since most do not have significant
intertwin hemoglobin discordance [12] , hormonal factors almost certainly play an important role as well [13] .
The presentation of TTTS is variable and its course main-
ly unpredictable. As such, TTTS may present as a slowonset disease or be rapidly progressive. Most likely, TTTS
encompasses different diseases with a variable contribu-
tion of transfusion imbalance, unequal placental sharing
and hormonal dysfunction.
tors almost certainly play an important role as well [13] .
The presentation of TTTS is variable and its course mainly unpredictable. As such, TTTS may present as a slowonset disease or be rapidly progressive. Most likely, TTTS
encompasses different diseases with a variable contribu-
tion of transfusion imbalance, unequal placental sharing
and hormonal dysfunction.