Document Detail


Treatment of twin-twin transfusion syndrome.
MedLine Citation:
PMID:  8414335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether therapeutic amniocentesis may improve outcomes in patients with twin-twin transfusion syndrome. METHODS: Thirteen patients with possible twin-twin transfusion syndrome were evaluated for treatment. Therapeutic amniocenteses were performed on nine, and four patients were managed conservatively depending on the clinical severity of the twin-twin transfusion syndrome. RESULTS: Therapeutic amniocenteses resolved the syndrome in three of nine cases, with an overall neonatal survival rate of 83.3% (15 of 18) and neonatal morbidity of 53.3% (eight of 15) among the survivors. The survival rate in patients with expectant management was 75% (six of eight), with a neonatal morbidity of 33.3% (two of six). An association between amniotic fluid status and fetal outcomes was observed. Patients with normalization of polyhydramniosoligohydramnios had the best outcomes. CONCLUSION: Early, aggressive amniocentesis may be an effective therapy for twin-twin transfusion syndrome. Therapeutic amniocentesis may have the capability to alter inter-fetal blood flow, possibly as a result of changes in intravascular pressure, which are related to changes in intra-amniotic pressure.
Authors:
M G Pinette; Y Pan; S G Pinette; P G Stubblefield
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  82     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-11-19     Completed Date:  1993-11-19     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  841-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Maine Medical Center, Scarborough.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis*
Female
Fetofetal Transfusion / mortality,  therapy*
Humans
Infant, Newborn
Infant, Newborn, Diseases / epidemiology
Oligohydramnios
Polyhydramnios
Pregnancy
Survival Rate

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


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