Document Detail

Aggressive therapeutic amniocentesis for treatment of twin-twin transfusion syndrome.
MedLine Citation:
PMID:  2002975     Owner:  NLM     Status:  MEDLINE    
Acute severe twin-twin transfusion syndrome occurs in about 1% of monochorionic twin gestations. In the most severe form, acute hydramnios develops in the recipient twin's sac and fetal hydrops may be present. The donor twin is anemic and oligohydramnios is present, so that the donor appears "stuck" in a cocoon made by its adherent amnion. In this report, aggressive therapeutic amniocentesis restored amniotic fluid volume to normal in both sacs in all pregnancies. Fetal hydrops resolved in three of five (60%) of the fetuses affected. Pregnancy was extended a mean 80 +/- 33 days (+/- 2 SD) and perinatal survival was 79%. These findings contrast dramatically with the virtual 100% mortality reported in the literature with no therapy. Repeated aggressive amniocentesis effectively reversed the physiology of twin-twin transfusion syndrome and should be the treatment of choice for acute hydramnios, which previously had no recommended therapy.
J P Elliott; M A Urig; W H Clewell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  77     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-04-18     Completed Date:  1991-04-18     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  537-40     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Good Samaritan Regional Medical Center, Phoenix, Arizona.
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MeSH Terms
Acute Disease
Amniocentesis* / methods
Fetofetal Transfusion / therapy*
Polyhydramnios / therapy*
Pregnancy Trimester, Second
Prospective Studies

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