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[Third circulation: twin transfusion syndrome].

H A Zondervan1, P Stoutenbeek, B Arabin

  • 1Afd. Verloskunde en Gynaecologie, Academisch Medisch Centrum/Universiteit van Amsterdam. hzonder@rijnstate.nl

Nederlands Tijdschrift Voor Geneeskunde
|June 16, 1999
PubMed
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Serious twin-to-twin transfusion syndrome (TTTS) affects 50-100 Dutch twins annually. Early ultrasound and interventions significantly improve survival rates for these high-risk pregnancies.

Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Twin-to-twin transfusion syndrome (TTTS) is a severe complication in monochorionic pregnancies.
  • The polyhydramnion-oligohydramnion sequence is a key indicator, with a dismal prognosis without intervention due to previable preterm birth.
  • Significant morbidity risks exist for the surviving twin if the other fetus demises.

Purpose of the Study:

  • To assess the incidence and outcomes of serious previable TTTS in the Netherlands.
  • To highlight the importance of early diagnosis and available therapeutic options for TTTS.

Main Methods:

  • Retrospective analysis of 61 TTTS cases identified across seven Dutch centers over three years.
  • Evaluation of interventions including intertwin membrane piercing, amniocenteses, and laser occlusion of chorionic vasculature.

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Main Results:

  • 36 out of 61 identified cases required intervention.
  • 63 out of 122 fetuses survived, with 10 experiencing long-term morbidity.
  • Early recognition through detailed ultrasound following monochorionicity diagnosis is crucial.

Conclusions:

  • Despite serious risks, therapeutic interventions for TTTS can lead to improved survival rates.
  • Multicenter collaboration and early detection are vital for managing TTTS effectively.
  • Ongoing monitoring and intervention strategies are necessary to reduce long-term morbidity in survivors.