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The following are indicators of the presence of twin-to-twin transfusion syndrome:

  • A uterus which is too large for the gestational age and associated complaints by the mother such as shortness of breath, feeling of tension or back pain, etc.
  • Ultrasound images of a shared placenta and same sex twins as well as the following characteristics:
    • noticeably increased amniotic fluid in one amniotic sac and full urinary bladder of the corresponding child
    • noticeably decreased amniotic fluid in the other amniotic sac and empty urinary bladder of the corresponding child
    • signs of heart problems in one twin (valve insufficiency, possible water retention in the body)
    • size difference between the twins

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