Outcome of pregnancies complicated by twin-twin transfusion syndrome in King Chulalongkorn Memorial Hospital.
OBJECTIVE
To study perinatal outcomes of pregnancies complicated by twin-twin transfusion syndrome (TTTS), which were treated with the authors' intervention modalities. Maternal outcomes of these populations were also explored.


METHODS
All pregnancies diagnosed TTTS that delivered in King Chulalongkorn Memorial Hospital between January 2000 and November 2009 were enrolled in this descriptive study Patients' data before August 2008 were retrospectively assessed. Perinatal survival, neonatal morbidities, and maternal outcomes were recorded and analyzed. Antenatal ultrasonographic findings were also analyzed to determine prognostic factors on perinatal outcomes.


RESULTS
Twenty-five cases of TTTS were recruited in the present study. Overall perinatal survival was 58% (29/50) with no significant difference in perinatal in among various stages of disease (p = 0.19). Survival in stage I-II, stage III, and stage IV were 64.3%, 45.8%, and 75%, respectively. There was no maternal mortality in the present study The most common maternal morbidity was preeclampsia (6/25; 24%). Progression of disease was the only significant prognostic fact or for perinatal mortality (p < 0.001).


CONCLUSIONS
Overall perinatal mortality rate of TTTS in the presented populations was still high (42%). Progression of disease was the only significant prognostic factor for poor perinatal outcome in the preset study Since the case number of the present study was too small, the conclusion that the prognosis of the conservatively treated TTTS was unrelated to the staging cannot be drawn.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand.
Suksan
S
Korpraphong
Somchai
S
Tanawattanacharoen
D000328:Adult; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology; D014430:Twins, Monozygotic; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055815:Young Adult