World TAPS Awareness Day Date in the current year: December 8, 2024

Twin-to-twin transfusion syndrome (TTTS) is a complication of identical twin pregnancy characterized by disproportionate blood supply between the fetuses. In addition to the classic form of TTTS, there are several variants of the syndrome: twin anemia polycythemia sequence (TAPS), selective intrauterine growth restriction (SIUGR or sIUGR), and twin reversed arterial perfusion sequence (TRAP sequence or TRAPS).

In classic TTTS, disproportionate blood supply results in unequal levels of amniotic fluid between the fetuses: one fetus has a lower than normal level of amniotic fluid in the amniotic sac (oligohydramnios), and the other has an excess amount of amniotic fluid (polyhydramnios). In TAPS, however, the fetuses disproportionately share red blood cells only, while the volume of blood and, therefore, amniotic liquid levels stay normal.

TAPS can occur spontaneously or develop after laser surgery for TTTS (post-laser TAPS); the latter form of TAPS is more common. Post-laser TAPS develops when the surgeon misses very small shared blood vessels during the procedure.

TAPS is a dangerous pregnancy complication that is life-threatening for both babies. The donor twin (the one that loses red blood cells) does not receive the appropriate amount of oxygen and nutrients, whereas the recipient twin (the one that receives red blood cells) is at risk of developing polycythemia (an abnormally high blood count), which can be fatal due to blood clots.

TAPS is often called the silent killer because it causes no physical symptoms in the mother and is typically not suspected until one of the twins gets extremely sick. The only way to diagnose it reliably is the MCA Doppler, a non-invasive test measuring the speed of blood in the mid-cerebral artery. When TAPS is diagnosed in utero, the only causal treatment is laser surgery. Depending on gestational age and TAPS stage, the doctor may suggest a wait-and-watch approach, intra-uterine blood transfusion, or preterm delivery.

World TAPS Awareness Day is one of four awareness days observed during World TTTS Awareness Month, alongside World TTTS Awareness Day, World SIUGR Awareness Day and World TRAP Awareness Day, observed on December 7, 9 and 10, respectively. It was created by the The Twin to Twin Transfusion Syndrome Foundation (TTTS Foundation).

The TTTS Foundation was established by Mary Salman, a woman who lost one of her twins to TTTS in 1989 and took a pledge to make sure her babies would be known and remembered. Salman coined the term “daisy babies” for babies who have survived TTTS, established the TTTS Foundation, and created awareness days to raise awareness of TTTS and its forms.

The main goals of World TAPS Day are to increase awareness of TAPS among both healthcare professionals and the general public, encourage research into TAPS, and provide help and support to families affected by the syndrome. You can join the campaign and shine a light on TAPS by posting on social media with the hashtags #TAPSisSilent, #FIGHTtaps, #WHATisTAPS and #WorldTAPSDay.