Twin-twin transfusion syndrome treated with serial amniocenteses.
BACKGROUND
To evaluate the treatment and neonatal outcome in pregnancies complicated by twin-twin transfusion syndrome (TTS).


METHODS
Twenty-four women with TTS were identified in the period 1993-99 among 34477 deliveries. We include a retrospective chart review of all twins with TTS.


RESULTS
The overall incidence of TTS was 4.75% of all twin pregnancies. The mean gestational age at the time of diagnosing TTS was 23 weeks (range 17.6-38), and the mean gestational age at delivery was 34.6 weeks (range 23.1-38.3). Therapeutic amniocenteses was performed in 21 women. The total volume drained varied from 0.4 to 32.31 with a mean of 2.3 l. Overall perinatal mortality in TTS was 35.4%, as nine donor twins and eight recipient twins died. The main causes for mortality were intrauterine death and prematurity.


CONCLUSIONS
Twin-twin transfusion syndrome is a severe complication in monochorionic diamniotic twin pregnancies, with high perinatal mortality and morbidity even though amnioreduction prolonged the pregnancies leading to better neonatal outcome.
Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway. Synnove.johnson@helse-bergen.no
Synnøve Lian
SL
Johnsen
Susanne
S
Albrechtsen
Jouko
J
Pirhonen
D000328:Adult; D000649:Amniocentesis; D005260:Female; D005330:Fetofetal Transfusion / Q000401:mortality* / Q000601:surgery*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014430:Twins, Monozygotic