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[Serial amniocentesis in TTTS].

K Szaflik, D Borowski, J Wilczyński

    Ginekologia Polska
    |November 18, 2000
    PubMed
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    Serial amniocentesis effectively prolongs gestation in twin-to-twin transfusion syndrome (TTTS) cases with acute polyhydramnios. This procedure, along with other therapies, improves perinatal outcomes for affected pregnancies.

    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.

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    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.