Abstract
Twin–twin transfusion syndrome (TTTS) is still one of the most challenging diseases of monochorionic twin pregnancies. The advent of ultrasonography revealed detailed of pathophysiology of the disease in utero, therefore we can be made aware of a new strategy to manage TTTS. Recently after randomized clinical trial, selective fetoscopic laser photocoagulation of communicating vessels (FLP) seems to become the optimal treatment for severe early onset TTTS, however, questions still remain for short- and long-term neurological and cardiovascular outcomes. To diagnose and manage TTTS favorably, it is quite important to have accurate diagnosis of chorionicity and amnionicity, fetal echocardiography including various Doppler studies, and the staging system of TTTS.