Septostomy with amniodrainage in the treatment of twin-to-twin transfusion syndrome: a 16-case report.
OBJECTIVE
To report the treatment results of 16 monochorionic and diamniotic gestations cases, which had complications due to the twin-to-twin transfusion syndrome (TTTS), the neonatal and other possible complications of the septostomy associated to the amniodrainage.


METHODS
Based on ultrasonographic findings, 16 pregnant women were diagnosed with the twin-to-twin transfusion syndrome (TTTS). These cases were divided in two groups: one of them included the fetuses without hydrops and the second included the "recipient" fetuses with hydrops. The therapy measures included septostomy with or without amniodrainage. The following parameters were evaluated: gestational age at the time the septostomy was performed, volume of drained amniotic fluid, gestational age at delivery, birth weight, postnatal evolution, and procedure complications.


RESULTS
The average gestational age for this procedure was of 23.6 weeks (from 14 weeks and 1 day to 33 weeks). The gestational age for the septostomy until the delivery was of 8.18 weeks (from 1.0 to 21.3 weeks). The survival rate in the group without hydrops was of 68.7%, while in the second group it was of 25%. Some of the complications were as follows: two cases of premature membrane rupture and one case of preterm labor.


CONCLUSIONS
Septostomy with amniodrainage, when performed on the initial stages and on earlier gestational ages has good perinatal results.
Saito
Maurício
M
Conceptus, Fetal Medicine Unit of Sao Paulo, São Paulo, Brazil.
Pontes
Ana Letícia Siqueira
AL
Porto Filho
Francisco Augusto
FA
Sousa
Francisco Lázaro Pereira
FL
Saito
Milton
M
Araujo Júnior
Edward
E
Guimarães Filho
Hélio Antonio
HA
Nardozza
Luciano Marcondes Machado
LM
Moron
Antonio Fernandes
AF
D000650:Amnion / Q000601:surgery*; D000653:Amniotic Fluid; D004322:Drainage; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D005330:Fetofetal Transfusion / Q000401:mortality / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000628:therapy; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D015996:Survival Rate