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Author(s): Julian E De Lia ; Randall S Kuhlmann ; Maurice G Emery Source: Twin Research Volume: 3 Number: 2 Page: 113 -- 117 DOI: 10.1375/136905200320565580 Publisher: Australian Academic Press Abstract: We report
abnormal maternal laboratory parameters in
twin-to-twin transfusion syndrome
(TTTS) at mid-pregnancy. A
retrospective chart review was undertaken of 109 patients with
TTTS
evaluated for placental laser surgery. Complete blood count (CBC),
blood type and Rh factor, urine analysis and serum chemistry panel
were obtained preoperatively, with the CBC and serum albumin
repeated on the first postoperative day. The mean gestational
age
was 21.2 ± 1.7 weeks. Initial abnormal values included
hematocrit
(32.1 ± 3.0%), hemoglobin (11.0 ± 1.03 g/dl), serum
magnesium
(1.71 ± 0.17 mg/dl), total protein (6.08 ± 0.55
g/dl) and albumin
(3.06 ± 0.34 g/dl). Despite minimal blood loss and conservative
fluid
replacement mean hematocrit, hemoglobin, and albumin were 27.3
± 2.74%,
9.3 ± 0.94 g/dl and 2.56 ± 0.23 g/dl, respectively
on postoperative
day one. Weight gain (8.0 ± 5.5 lb.) and low urinary output
were
characteristic peri- operative events. Maternal hypoproteinemia
and anemia occur in TTTS at mid- pregnancy. This may contribute
independently to amniotic fluid production rates in the fetuses,
and
explain in part the maternal sensitivity to intravenous fluids
in
multiple pregnancy.
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Copyright © 1997-2004 The Twin
To Twin Transfusion Syndrome Foundation. All Rights Reserved
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