Termination of the Entire Pregnancy:
When pregnancy termination (induced abortion) is recommended by doctors and counselors, it is done so not as a treatment, per se, but as a reflection of their lack of faith in the available therapies for TTTS. The Twin to Twin Transfusion Syndrome Foundation is a pro-twin and, therefore, a pro-life organization. We are in the business of hope, and there is always hope. Certain doctors refuse to believe that parents would risk any health problems in their surviving TTTS babies, and would terminate all TTTS cases despite the fact that the majority of twins survive and are normal regardless of treatment used. Some physicians accomplish this end by 'passive neglect.' This is where there are signs of significant TTTS on ultrasound, and the doctor asks the patient to return weeks later instead of one week hoping the pregnancy ends in the meantime. The babies can live, please give the parents the opportunity to save their babies. They all deserve the 'right to try.'
Selective Termination of One Baby by Various Methods:
The termination of one twin (with the hope that the pregnancy will continue for the other) is undertaken for various reasons. Perhaps one reason is when a severe birth defect baby, known as an acardiac MC twin (here an identical twin is deformed and does not have a formed heart), is kept 'alive' by the normally formed twin who pumps blood to the acardiac twin through the placental blood vessel connections. The normal 'pump' twin may go into heart failure due to the strain. The various techniques to separate these twins include ligation of the umbilical cord with suture, or the cauterization of the cord with laser or electric current. Methods must be used that occlude the umbilical cord or major fetal vessels in the deformed baby to avoid death or damage (especially of the brain) to the other normal baby as a result of an acute transfusion through the connections. Sadly, some doctors use this technique in TTTS when they either fail at attempted laser surgery, or when they feel that one twin may have a poor outlook. We have seen babies in heart failure with hydrops, a chosen baby for cord ligation, have laser surgery and live and be completely healthy.