title: Indomethacin in severe twin-to-twin transfusion syndrome.
abstract: Despite advances in maternal fetal medicine, the management of severe twin-to-twin transfusion syndrome in the second trimester presents a significant challenge. Presently, there is no uniformly accepted management protocol that is available for the treatment of this syndrome. We report the use of indomethacin in three cases of severe twin-to-twin transfusion syndrome in the second trimester. In the three cases of severe twin-to-twin transfusion syndrome no reduction of amniotic fluid in either sac was demonstrated. Two cases were complicated by single intrauterine fetal death within 72 hours of initiating indomethacin therapy. Because of our experience with these three cases, we conclude that indomethacin does not prevent perinatal mortality in patients with severe twin-to-twin transfusion syndrome.
authors.affiliation: Department of Maternal Fetal Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts.
authors.forename: J M
authors.initials: JM
authors.lastname: Jones
authors.forename: A J
authors.initials: AJ
authors.lastname: Sbarra
authors.forename: L
authors.initials: L
authors.lastname: Dilillo
authors.forename: C L
authors.initials: CL
authors.lastname: Cetrulo
authors.forename: M E
authors.initials: ME
authors.lastname: D'Alton
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D005330:Fetofetal Transfusion / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
chemical_list: D007213:Indomethacin