Document Detail


Normalization of amniotic fluid levels after fetoscopic laser surgery for twin-twin transfusion syndrome.
MedLine Citation:
PMID:  20876896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to describe amniotic fluid (AF) normalization after laser surgery for twin-twin transfusion syndrome (TTTS).
METHODS: Patients with TTTS (n = 174) who had laser surgery from 2006 through 2009 underwent serial measurements of the AF maximum vertical pockets (MVPs) during postoperative weeks 1 through 10. A normal MVP was defined as greater than 2 cm and less than 8 cm. Postoperative TTTS criteria required an MVP of 2 cm or less in one sac and 8 cm or greater in the other sac. Patients with septostomy, immediate fetal death, or missing MVP values were excluded.
RESULTS: Inclusion criteria were met by 115 patients. Normalization of the MVP occurred by week 5 in donors and week 8 in recipients in approximately 95% of the cases. Recipient fetuses with Quintero stage 3 or 4 TTTS (J Perinatol 1999; 19:550-555) were more likely to have an abnormal MVP than those with stage 1 or 2 TTTS during weeks 3 and 4 (P = .0049) and 5 and 6 (P = .0239). The criteria for TTTS were met in 6 cases (6.9%) in week 1: 5 resolved spontaneously, and 1 (1.2%) had persistent TTTS and required a second laser surgery. After week 1, 6 additional patients had abnormal MVP values for both fetuses simultaneously: 1 met TTTS criteria in week 3; 2 had oligohydramnios in week 2; and 3 had polyhydramnios in weeks 2, 4, and 7; none of these patients required further interventions.
CONCLUSIONS: Although the AF of individual donor and recipient fetuses may take several weeks to normalize after laser surgery for TTTS, it is rare for both fetuses to meet TTTS criteria beyond the first postoperative week.
Authors:
Samer A Assaf; Lisa M Korst; Ramen H Chmait
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  29     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1431-6     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid
Female
Fetofetal Transfusion / surgery
Fetoscopy*
Fetus / surgery*
Humans
Laser Therapy / methods*
Oligohydramnios / etiology
Polyhydramnios / etiology
Postoperative Period
Pregnancy
Retrospective Studies
Ultrasonography, Prenatal

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


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