Controlled amnioreduction for twin-to-twin transfusion syndrome
Zoya Gordon1, Aviva Fattal-Valevski2, David Elad3
1Ultrasound Unit in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 64239, Israel.
Therapeutic Advances in Reproductive Health
|April 4, 2022
Summary
This study shows a new amnioreduction (AR) protocol for twin-to-twin transfusion syndrome (TTTS) improves twin survival and long-term neurodevelopmental outcomes in survivors.
Area of Science:
- Perinatology
- Fetal Medicine
- Neonatology
Background:
- Twin-to-twin transfusion syndrome (TTTS) is a serious pregnancy complication.
- TTTS can lead to preterm birth, fetal demise, and neurodevelopmental issues.
Purpose of the Study:
- To present a data-driven, controlled amnioreduction (AR) protocol for TTTS treatment.
- To evaluate the efficacy of sequential amniodrainage in managing TTTS.
Main Methods:
- 18 AR procedures were conducted on 11 TTTS pregnancies (17-34 weeks gestation).
- Amniotic fluid was removed in 500 mL increments, monitoring amniotic pressure.
- Umbilical artery S/D ratios and long-term neurodevelopmental outcomes were assessed.
Main Results:
- Amniotic pressure decreased exponentially, reaching a plateau.
- The survival rate was 86.4%, with 91% of twins at Quintero stage III.
- 68.4% of survivors had optimal neurodevelopmental outcomes.
Conclusions:
- Controlled AR protocol is effective in treating TTTS.
- The procedure yields high twin survival rates.
- Favorable long-term neurodevelopmental outcomes were observed in survivors.
Keywords:
S/D ratioamniotic fluidamniotic pressurelong-term neurodevelopmenttwin pregnanciestwin survival
