F44Serial amniocentesis in twin Transfusion syndrome

Abstract

BackgroundThe aim of our study was to estimate the efficiacy of serial amniocentesis in cases of acute polyhydramnion in TTS.MethodThe study group consisted of 13 pairs of twins with sonographically confirmed hydramnios. After the examination patients were prepared for amnioreduction. During the procedure the excess of amniotic fluid was removed through the punction needle.ResultsThe mean gestational age was 24.3 ± 2.9 weeks in the range 22–29 weeks. In 6 cases polyhydramnion/oligohydramnion was found. The therapy of TTS was based mainly on serial amniocentesis.The mean gestational age during delivery was 27.6 ± 3 weeks. The mean interval between the diagnosis and delivery was 3.3 weeks. In all cases the deliveries were preterm. The mean donor weight was 730 ± 290 g and the mean recipient weight was 1145 ± 435 g. The difference between the recipients and donors was approximately 37%. In 7 cases we observed an intrauterine demise of one fetus. The 5th min Apgar score was 1 pt (median). When the analysis was performed after exclusion of stillborns, the median Apgar score for donors and recipients was 4 and 2 pt, respectively.ConclusionSerial amniocentesis are effective in significant prolongation of gestation (the mean interval between diagnosis and delivery 24 days). The improvement of perinatal outcomes in twin gestations complicated by TTS can be achieved by the combination of serial amniocentesis and the laser ablation.