| Fetal
Diagn Ther. 1997 Jan-Feb;12(1):15-20.
Serial amniocenteses in the management of twin-twin
transfusion syndrome: when is it valuable?
http://www.ncbi.nlm.nih.gov:80/entrez/
query.fcgi?cmd=
Retrieve&db=PubMed&list_uids=
9101215&dopt=Abstract
Trespidi L, Boschetto C, Caravelli
E, Villa L,
Kustermann A, Nicolini U.
1st Department of Obstetrics
and Gynecology,
University of Milan, Italy.
Serial decompressive amniocenteses
were
performed at 18-23 weeks of gestation in 23
pregnancies referred due to echographic signs
typical of twin-twin transfusion syndrome. The
procedures were repeated until delivery or
permanent normalization of the amniotic fluid
volume both in the donor and the recipient twin
sac. The overall survival rate was 57%, but in
only 39% of the pregnancies did both twins
survive without handicaps. The absence of
end diastolic flow in the umbilical artery of the
donor twin was associated with poor chances
of survival for both fetuses; in contrast, the
presence of hydrops or ascites in the recipient
twin did not worsen the prognosis. A policy of
aggressive amniotic fluid decompression may
achieve permanent resolution of the fluid in over
50% of the pregnancies complicated by twin-twin transfusion
syndrome.
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