Outcome of twin-twin transfusion diagnosed before 28 weeks of gestation.
To develop prognostic indicators for those patients diagnosed with twin-twin transfusion before 28 weeks' gestation, we conducted a retrospective analysis of all cases diagnosed at Baylor College of Medicine from January 1985 through April 1989. Twenty-seven cases of twin-twin transfusion were diagnosed by ultrasound; the criteria for diagnosis were polyhydramnios in one amniotic cavity and oligohydramnios in the other cavity. The mean (+/- SD) age at diagnosis was 21.9 +/- 2.9 weeks and the mean age at delivery was 26.8 +/- 4.9 weeks. Gestational age at diagnosis was similar in survivors and non-survivors (21.7 +/- 3.7 versus 22.2 +/- 2.8 weeks; P = .35); however, surviving infants were delivered later in gestation (31.9 +/- 3.5 versus 25.9 +/- 3.4 weeks; P = .000008). The overall survival rate was 21%. Fetal hydrops correlated with poor survival. Amniocentesis for decompression and tocolysis failed to decrease perinatal mortality.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
W
W
Gonsoulin
K J
KJ
Moise
B
B
Kirshon
D B
DB
Cotton
J M
JM
Wheeler
R J
RJ
Carpenter
D000328:Adult; D000649:Amniocentesis; D005260:Female; D005330:Fetofetal Transfusion / Q000175:diagnosis* / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D006831:Polyhydramnios / Q000628:therapy; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D015149:Tocolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D014463:Ultrasonography
D015149:Tocolytic Agents