[Analysis of the perinatal outcomes and management of twin-twin transfusion syndrome].
OBJECTIVE
To investigate the perinatal outcomes of twin-twin transfusion syndrome (TTTS) and the management.


METHODS
During Nov 1, 2002 to Sep 30, 2005, 24 cases of TTTS in Beijing Obstetrics and Gynecology Hospital were analyzed. The outcomes of them were compared with the pregnancy without TTTS in all twins and in monozygotic twins. The outcomes of the blood-supplying fetus and the blood-recepter were compared.


RESULTS
6.8% cases had TTTS in all twins. The group of TTTS had more maternal, fetal and neonatal complications than twins pregnancy without TTTS: polyhydramnios [37.5% (9/24) vs 2.1% (7/328), P < 0.01], gestational hypertension [20.8% (5/24) vs 7.0% (23/328), P = 0.043], premature labor [66.7% (16/24) vs 36.3% (119/328), P = 0.003], perinatal dead fetus in uterus [18.8% (6/32) vs 1.1% (7/640), P < 0.01], neonatal asphyxia [73.1% (19/26) vs 3.0% (19/632), P < 0.01], the proportion of NICU [88.5% (23/26) vs 23.4% (148/632), P < 0.01], neonatal death [15.4% (4/26) vs 1.7% (11/632), P = 0.002] and the rate of perinatal mortality [31.2% (0/32) vs 2.8% (18/632)]. Compared with the monozygotic twins without TTTS, in TTTS group there were more complications of the mother, the fetus and the neonates: gestational hypertension [20.8% (5/24) vs 9.9% (14/142), P = 0.224], premature labor [66.7% (16/24) vs 49.3% (70/142), P = 0.115], perinatal dead fetus in uterus [18.8% (6/32) vs 0.7% (2/282), P < 0.01], neonatal asphyxia [73.1% (19/26) vs 3.9% (11/280), P < 0.01], the proportion of NICU [88.5% (23/26) vs 29.3% (82/280), P < 0.01], neonatal death [15.4% (4/26) vs 2.1% (6/280), P = 0.006] and the rate of perinatal mortality [31.3% (10/32) vs 3.2% (8/282)]. The perinatal outcomes were better in those cases that the grades of TTTS were below 3 in the first diagnosis.


CONCLUSIONS
We should try to diagnose and treat TTTS as early as possible because the outcome is poor.
Kong
Li-Jun
LJ
Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
Huang
Xing-Hua
XH
D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology / Q000209:etiology; D004200:Diseases in Twins; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D006831:Polyhydramnios / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D014427:Twins; D014430:Twins, Monozygotic; D055815:Young Adult