Document Detail


Amnioreduction versus septostomy in twin-twin transfusion syndrome.
MedLine Citation:
PMID:  11717630     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to compare treatment outcomes in pregnancies affected with twin-twin transfusion syndrome. Treatment consisted of serial amnioreduction or septostomy. STUDY DESIGN: A retrospective review of patients who were diagnosed with twin-twin transfusion syndrome from June 1998 to June 2000 was conducted. Diagnosis was based on polyhydramnios (maximal vertical pocket, >8 cm) in conjunction with an enlarged fetal bladder, oligohydramnios (maximal vertical pocket, <2 cm) with nonvisualization of the fetal bladder, and documentation of a single placenta. Data evaluated were gestational age at enrollment and delivery, prolongation of gestation, and number of surviving fetuses by treatment modality. RESULTS: There were 7 patients in the amnioreduction group and 7 patients in the septostomy group. The mean gestational age at enrollment for amnioreduction was 21.0 weeks and for septostomy was 18.0 weeks (P =.01). There were 67% 2-twin survivors in the septostomy group (P = not significant), but an overall equal number of survivors (78%) in both treatment groups. The rate of no surviving twins was equal (14%) in both groups. Pregnancy was prolonged an average of 12 weeks in the septostomy group and 6.5 weeks in the amnioreduction group (P =.007). The average gestational age at delivery was 27.5 weeks for the amnioreduction group and 30.0 weeks for the septostomy group (P =.08). CONCLUSION: The prolongation of pregnancy from diagnosis to delivery was statistically significant for septostomy when compared to amnioreduction. Although not statistically significant, there appears to be a trend toward increasing gestational age at delivery with septostomy. Further randomized studies are warranted for septostomy as a treatment modality in twin-twin transfusion syndrome.
Authors:
J R Johnson; K Q Rossi; R W O'Shaughnessy
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  185     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-21     Completed Date:  2001-12-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1044-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, The Ohio State University School of Medicine and Public Health, Columbus 43210, USA. johnson.1827@osu.edu
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MeSH Terms
Descriptor/Qualifier:
Amniocentesis*
Cross-Sectional Studies
Delivery, Obstetric
Female
Fetofetal Transfusion / mortality,  therapy*
Gestational Age
Heart Septum / surgery*
Humans
Pregnancy
Retrospective Studies
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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