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Twin‐to‐twin transfusion syndrome presenting at early stages: is there still a possible role for amnioreduction?
Author(s) -
Fichera Anna,
Lanna Mariano,
Fratelli Nicola,
Rustico Mariangela,
Frusca Tiziana
Publication year - 2010
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2430
Subject(s) - medicine , gestation , twin to twin transfusion syndrome , obstetrics , stage (stratigraphy) , pregnancy , twin twin transfusion syndrome , pediatrics , surgery , fetus , paleontology , genetics , biology
Abstract Objective To assess the rate of resolution or progression after first line treatment with amnioreduction and related outcome of pregnancies with twin‐to‐twin transfusion syndrome (TTTS) diagnosed at stages I‐II. Method Data on 34 monochorionic diamniotic twin pregnancies presenting with TTTS at stage I‐II before 26 weeks of gestation were collected retrospectively (1999–2006). All patients underwent at least one amnioreduction. The outcome and the results of neurological follow‐up of surviving twins were analysed in relation to the regression or progression of the disease after treatment. Results Fourteen cases (41%) resolved after treatment while 18 cases (53%) progressed. In two patients immediate complications occurred within one week after amnioreduction; at least one infant survived in 85.3% of cases and there was double survival in 58.8%. Double survival was significantly better in cases that regressed (85.7%) compared with those cases that progressed (44.4%). None of the surviving infants in the group of cases with regression showed major neurological abnormalities. Conclusion In our study, one‐third of patients with stage I‐II TTTS regressed after a single amnioreduction, and pregnancies with resolution of TTTS usually had a favourable outcome. Copyright © 2009 John Wiley & Sons, Ltd.