Could a Blood Test Help Predict TTTS Earlier?

One of the major challenges in twin-to-twin transfusion syndrome is identifying which monochorionic twin pregnancies will develop the condition before the characteristic signs become visible on ultrasound.

A research study published in 2021 investigated whether changes in the mother’s metabolism could provide an earlier warning.

Researchers analysed maternal blood collected between 11 and 15 weeks of pregnancy from women carrying monochorionic-diamniotic twins. They compared pregnancies that subsequently developed TTTS with pregnancies that remained uncomplicated.

The researchers identified differences in several groups of metabolites, including fatty acids, amino acids and substances involved in energy metabolism. Importantly, these differences could be detected before the ultrasound findings used to diagnose TTTS appeared.

This was a pilot study, so the findings do not provide a diagnostic blood test and require further research and validation. However, they demonstrate an important possibility: biological changes associated with TTTS may begin early enough to be detected before the condition becomes clinically apparent.

Professor Mark Kilby was funded for this work by a grant from The Richard and Jack Wiseman Trust.

Research into earlier prediction is particularly important because identifying high-risk pregnancies sooner may ultimately allow closer surveillance and earlier intervention.

Read the research on PubMed