Biomaterial Database

Twin-to-twin transfusion syndrome: aggressive therapeutic amniocentesis. 1997

L G Dennis, and C L Winkler

Prenatal Diagnostic Center, Carilion Center for Women and Children, Roanoke, VA, USA.

OBJECTIVE Untreated twin-to-twin transfusion syndrome reportedly carries nearly a 100% mortality rate. Over the last decade a number of therapeutic modalities have been attempted, including aggressive amniocentesis. This study was a retrospective evaluation of a series of 22 patients with twin-to-twin transfusion syndrome referred to our prenatal diagnostic center to determine the effectiveness in treating twin-to-twin transfusion syndrome with aggressive therapeutic amniocentesis. METHODS In this study three patients did not meet diagnostic criteria. For various reasons six patients did not have therapeutic amniocentesis done. One patient chose to terminate the pregnancy after three amniocenteses. Another patient chose to discontinue therapy after removal of just 100 ml of amniotic fluid. Of the 11 treated patients, the mean gestational age at diagnosis was 22 weeks 4 days (range 15 weeks 4 days to 26 weeks 4 days). RESULTS The mean number of amniocenteses done was 5.5 (range 1 to 12). The mean total of amniotic fluid removed over the course of the pregnancy was 8.0 L (range 1100 to 24,200 ml). The mean number of days gained in these pregnancies was 56 (range 9 to 125) compared with 54 days for the untreated women. Eighty-two percent of the treated fetuses survived compared with 50% in the untreated group. Newborns in the treated group were delivered at a later gestational age and weighed more than those in the untreated group. CONCLUSIONS Spontaneous resolution of twin-to-twin transfusion syndrome does occur. Therapeutic amniocentesis offers a simple, effective method of therapy for twin-to-twin transfusion syndrome.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297	Male		Males
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D001724	Birth Weight	The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms.	Birthweight,Birth Weights,Birthweights,Weight, Birth,Weights, Birth
D005260	Female		Females
D005313	Fetal Death	Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH.	Fetal Mummification,Fetal Demise,Death, Fetal,Deaths, Fetal,Demise, Fetal,Fetal Deaths,Mummification, Fetal
D005330	Fetofetal Transfusion	Passage of blood from one fetus to another via an arteriovenous communication or other shunt, in a monozygotic twin pregnancy. It results in anemia in one twin and polycythemia in the other. (Lee et al., Wintrobe's Clinical Hematology, 9th ed, p737-8)	Cross-Transfusion, Intrauterine,Intrauterine Cross-Transfusion,Twin Transfusion,Twin Transfusion Syndrome,Twin-to-Twin Transfusion,Fetal Transfusion Syndrome,Fetofetal Transfusion Syndrome,Twin Twin Transfusion Syndrome,Twin-to-Twin Transfusion Syndrome,Cross Transfusion, Intrauterine,Fetal Transfusion Syndromes,Fetofetal Transfusion Syndromes,Fetofetal Transfusions,Intrauterine Cross Transfusion,Intrauterine Cross-Transfusions,Syndrome, Fetal Transfusion,Syndrome, Fetofetal Transfusion,Syndrome, Twin Transfusion,Syndrome, Twin-to-Twin Transfusion,Transfusion Syndrome, Fetal,Transfusion Syndrome, Fetofetal,Transfusion Syndrome, Twin,Transfusion Syndrome, Twin-to-Twin,Transfusion, Fetofetal,Transfusion, Twin,Transfusion, Twin-to-Twin,Twin Transfusion Syndromes,Twin Transfusions,Twin to Twin Transfusion,Twin to Twin Transfusion Syndrome,Twin-to-Twin Transfusion Syndromes,Twin-to-Twin Transfusions
D005865	Gestational Age	The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination.	Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths