We cannot stress enough the importance for every pregnant woman to have an ultrasound within the first 3 months of pregnancy. During this time, you can find out if you have having multiples. If you are having multiples, a sonographer can tell you with 100% accuracy, as early as 7 menstrual weeks, how many placentas there are (chorionicity). If the placenta is monochorionic, single, your pregnancy is at risk for TTTS.
Knowing the chorionicity completely changes the management of your pregnancy. The sooner you know the chorionicity, you can begin making a medical plan of action for your babies to include having a maternal-fetal medicine specialist, or perinatologist, as your doctor and to have weekly ultrasounds starting at 16 weeks through delivery of your babies to look for signs of TTTS, placental share problems and cervix problems. You can also get an early start on improving your nutrition and getting as much horizontal rest as possible to help take pressure off your cervix and increase blood and oxygen to the placenta.
IF YOU HAVE A MONOCHORIONIC PLACENTA, THE TWIN TO TWIN TRANSFUSION SYNDROME FOUNDATION ADVOCATES THAT YOU RECEIVE WEEKLY ULTRASOUNDS WITH A PERINATOLOGIST FROM WEEK 16 THROUGH THE DELIVERY OF YOUR BABIES WHETHER YOU ARE DIAGNOSED WITH TTTS OR NOT.
IF CHORIONICITY IS UNCERTAIN FOR WHATEVER REASON, IT IS CRUCIAL TO MANAGE AS A MONOCHORIONIC GESTATION WITH ESPECIALLY TARGETED FOLLOW-UP AND MONITORING.