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Fetal and neonatal outcomes in twin oligohydramnios-polyhydramnios sequence including cerebral palsy
Yoshio Matsuda1, Satoshi Kouno
1Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan. ymatsuda@obgy.twmu.ac.jp
Objective:
The purpose of this study was to review consecutive pregnancies complicated by twin oligohydramnios-polyhydramnios sequence (TOPS) and to clarify the probable factors influencing the perinatal outcomes.
Methods:
Twenty-five pregnancies with a diagnosis of TOPS were treated with and without amniocentesis. A poor perinatal outcome was defined when either perinatal mortality or cerebral palsy was observed.
Results:
The mean gestational age at the time of diagnosis and of delivery was 27.8 (range 21-34) and 30.7 (range 23-35) weeks, respectively. Tocolytic therapy and therapeutic amniocentesis were done in 16 (64%) and 13 (52%) cases. Hydrops fetalis was present in 10 cases. The survival rate was 72%, and cerebral palsy was diagnosed in 8 of 36 infants (22%). The poor prognostic factors were gestational age at delivery (<30 weeks) and presence of symptomatic preterm labor and hydrops fetalis. Therapeutic amniocentesis did not influence the perinatal outcome.
Conclusions:
In this observational study, the long-term as well as the short-term perinatal outcome of pregnancy with TOPS seems to be poor. In addition, therapeutic amniocentesis in TOPS does not appear to affect fetal and neonatal outcomes.