[Serial amniocentesis in TTTS]

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Reproductive Medicine

Background:

• Twin-to-twin transfusion syndrome (TTTS) is a serious complication in monochorionic twin pregnancies.
• Acute polyhydramnion is a frequent and severe manifestation of TTTS.
• Associated pathologies include preterm labor, intrauterine growth restriction, and cardiac failure.

Purpose of the Study:

• To evaluate the efficacy of serial amniocentesis for managing acute polyhydramnion in TTTS.
• To analyze delivery timing, route, and neonatal outcomes in these cases.

Main Methods:

• The study included 13 twin pregnancies diagnosed with TTTS and hydramnion.
• Serial amniocentesis was performed to remove excess amniotic fluid.
• Additional therapies like indomethacin and digoxin were used in some cases.

Main Results:

• Serial amniocentesis significantly prolonged gestation, with a mean interval of 24 days between diagnosis and delivery.
• Mean donor weight was 730g and recipient weight was 1145g.
• High rates of preterm delivery and intrauterine fetal demise were observed; Apgar scores were low.

Conclusions:

• Serial amniocentesis is effective in prolonging gestation in acute TTTS with polyhydramnion.
• Combined therapies, including laser ablation, can improve perinatal outcomes.
• Acute TTTS requires prompt management due to associated severe pathologies.