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TTS and sepstostomyFrom: Kenneth J. Moise (kmoise@bcm.tmc.edu)Wed Oct 30 23:14:23 1996
Dan Braun asked how this septostomy thing workds for TTS. The answer is : we don't know. What we believe is that something starts the cascade of inappropriate sharing of the placenta vasculature (perhaps a viral infection in one of the twins). This leads to the poly/oligo sequence which may worsen the shunt through the increased amniotic fluid pressure in the poly sac. We have conjectured that the increased pressure is somehow transmitted to the placental vasculature. George Saade has pointed out that monoamniotic twins (with one amniotic cavity and many "shared placental vessels" ) don't get TTS. The answers are yet forthcoming on what is the pathophysiology of this syndrome. Ken Moise Baylor College of Medicine
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