Past Events

Current Advances in Twin to Twin Transfusion Syndrome

Aired on 6.07.2016
Current Advances in Twin to Twin Transfusion Syndrome CME
SAVE THE DATE! On June 7th, our live event will feature Twin to Twin Transfusion Syndrome Case/Scenario Discussion with panel experts and invited speakers to provide, both opposing and complimentary, approaches to treatment of these cases. Hosted by the Cincinnati Fetal Center with invited speakers from around the world to speak about the varying approaches to Twin to Twin Transfusion Syndrome. The symposium will be broadcast live to a virtual audience from Cincinnati, OH. The interactive format includes case presentations and discussion by key opinion leaders from around the world with audience and faculty interaction, discussion, polling and debate.


Monochorionic twin pregnancies are at a 10% risk of developing twin-twin transfusion syndrome (TTTS). Laser therapy is the standard of care treatment. Despite that there is still to date significant complications and challenges in this population, including iatrogenic preterm premature rupture of membranes (PPROM), short cervix, recurrence or reversal of TTTS, anomalous fetus in such setting and adverse long-term neurodevelopmental outcome in 6–18% of survivors. A multidisciplinary team approach is vital to these patients. Clinical team members need access to national and international experience in order to establish better understanding of the pathophysiology of this disease as well as open a new paradigm for collaborative research among nation.

Directors & Faculty


Foong-Yen Lim, MD

Surgical Director, Cincinnati Fetal Center.  Pediatric Surgeon, Division of General and Thoracic Surgery.  Associate Professor, University of Cincinnati Department of Surgery

Mounira Habli, MD

Maternal-Fetal Medicine Specialist, Cincinnati Fetal Center.  Associate Professor, Good Samaritan Hospital

Additional Faculty

Elena Carreras, MD

Head of Obstetric and Reproductive-Endocrinology Department Associated Professor Universitat Autonoma Barcelona (UAB) President Catalan Society of Obstetrics and Gynecology

Timothy Crombleholme, MD

The Ponzio Chair and Surgeon-in-Chief at Children’s Hospital Colorado and Professor and Vice Chair of the Department of Surgery at the University of Colorado School of Medicine.

Stephen Emery, MD

Associate Professor of Obstetrics, Gynecology and Reproductive Sciences
University of Pittsburgh School of Medicine
Director, Center for Innovative Fetal Intervention
Magee-Womens Hospital of UPMC

Ronald K. Jaekle, MD

Maternal-Fetal Medicine Co-Director, Cincinnati Fetal Center.  Professor, University of Cincinnati Department of Obstetrics & Gynecology

Anthony Johnson, DO

Professor of Obstetrics, Gynecology & Reproductive Sciences Professor of Pediatric Surgery McGovern Medical School at The University of Texas Health Science Center at Houston Co-Director, The Fetal Center at Children’s Memorial Hermann Hospital

Paul S. Kingma, MD, PhD

Neonatal Director, Cincinnati Fetal Center.  Associate Professor, University of Cincinnati Department of Pediatrics

Julie Moldenhauer, MD

Medical Director of the Garbose Family Special Delivery Unit; Assistant Prof. of Clinical Ob & GYN in Surgeyr, Perelman School of Medicine at the University of Pennsylvania. Philadelphia, Pennsylvania.

Ramesha Papanna, MD, MPH

The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX

Jose Peiro, MD

Endoscopic Fetal Surgery Director, Cincinnati Fetal Center. Pediatric Surgeon, Division of General and Thoracic Surgery. Associate Professor, University of Cincinnati Department of Surgery

William J. Polzin, MD

Maternal-Fetal Medicine Co-Director, Cincinnati Fetal Center. Director, Division of Maternal-Fetal Medicine, Good Samaritan Hospital

Todd Ponsky, MD

Todd Ponsky is currently Professor of Surgery at the University of Cincinnati and a pediatric surgeon at Cincinnati Children’s Hospital Medical Center and Akron Children’s Hospital. He is the Director of Clinical Growth and Transformation at Cincinnati Children’s Hospital. He attended medical school at Case Western Reserve University in Cleveland, Ohio from 1995-1999,Residency in General Surgery at The George Washington University in Washington, DC from 1999-2005, Pediatric Surgery Fellowship at Children's National Medical Center in Washington, DC from 2005-2007,and an Advanced Minimally Invasive Pediatric Surgery Fellowship at The Rocky Mountain Hospital for Children in Denver, CO from 2007-2008. Dr. Ponsky was the first to perform and report single port surgery in children and modernized the methods of the laparoscopic pediatric hernia repair. He has published over 125 manuscripts, edited 3 textbooks, and authored over 30 book chapters. He has directed over 50 national/international courses and has given over 200 visiting lectureships. He is the Associate Editor for The Journal of Pediatric Surgery, and serves on three editorial boards. He is the immediate past president of the International Pediatric Endosurgery Group (IPEG) and holds, or has held, leadership positions in the American College of Surgeons (ACS), the American Pediatric Surgical Association (APSA), the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the International Society for Pediatric Innovation (iSPI). He has won numerous faculty teaching awards. He is involved in both outcomes and animal research with a focus on inguinal hernia physiology, surgical telementoring, endoscopic repair techniques for pure esophageal atresia, and innovations in education. He founded GlobalcastMD and Stay Current in Surgery, both of which serve to democratize and internationalize medical knowledge and modernize the way we teach and learn surgery.

Greg Ryan, MB

Head of Maternal-Fetal Medicine, Mount Sinai Hospital

Aimen Shaaban, MD

Fetology Chicago Course Director
Director, The Chicago Institute for Fetal Health
Professor of Surgery and Pediatrics

Sammy Tabbah, MD

Maternal-Fetal Medicine Specialist, Cincinnati Fetal Center. Assistant Professor, University of Cincinnati Department of Surgery

James W. Van Hook, MD

Director, Maternal-Fetal Medicine, University of Cincinnati College of Medicine, The Christ Hospital, Professor, UC Department of Pediatrics
Maternal-Fetal Medicine Co-Director, Cincinnati Fetal Center.


1:00 pm - 1:10 pm
Introduction by Global Cast Moderator
1:10 pm - 3:00 pm
Session 1: Management Approaches
1:10 pm - 1:50 pm
Advances in Stage I Management
(10 min) Moderators: Sammy Tabbah & Foong-Yen Lim (CFC) (20 min) Speaker: Steve Emery (Magee/UPMC) (10 min) Discussion/Q&A

1:50 pm - 2:50 pm
Short cervix
(10 min) Moderators: Ron Jaekle & Jose Peiro (CFC) (20 min each) Speakers: Elena Carreras (Spain) vs. Ramesha Papanna (USA) (10 min) Discussion/Q&A

2:50 pm - 3:05 pm
3:05 pm - 5:00 pm
Session 2: TTTS and more
3:05 pm - 4:05 pm
Stage IV
(10 min) Moderators: Bill Polzin & Greg Ryan (CFC/Toronto) (20 min each) Speakers: Julie Moldenhauer (CHOP) vs. Tony Johnson (Houston) (10 min) Discussion/Q&A

4:05 pm - 5:00 pm
IUGR & Triplets
(5 min) Moderators: Aimen Shaaban, James VanHook & Mounira Habli (CFC) (20 min) Speaker: IUGR - Tim Crombleholme (Colorado) (20 min) Speaker: Triplets - Foong-Yen Lim (10 min) Discussion/Q&A

Topics Covered

TTTS Management Approaches, complications, TTTS with anomalous fetus


  1. Acquire current care management tool for stage I twin to twin transfusion syndrome worldwide.
  2. Give examples of care management of twin to twin transfusion syndrome patients complicated with short cervix and PPROM.
  3. Apply counseling and treatment options for twin to twin transfusion syndrome patients complicated with anomalous fetus or hydropic fetus or severe growth restricted fetus.

Disclosures and Accreditation Statement

Cincinnati Children’s Hospital Medical Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Cincinnati Children’s designates this live activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity
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