This paper was presented at the 10th International Conference on Prenatal Diagnosis and Therapy, 19–21 June 2000, Barcelona, Spain.
Rapid and radical amniodrainage in the treatment of severe twin–twin transfusion syndrome†
Article first published online: 18 MAY 2001
Copyright © 2001 John Wiley & Sons, Ltd.
Volume 21, Issue 6, pages 471–476, June 2001
How to Cite
Jauniaux, E., Holmes, A., Hyett, J., Yates, R. and Rodeck, C. (2001), Rapid and radical amniodrainage in the treatment of severe twin–twin transfusion syndrome†. Prenat. Diagn., 21: 471–476. doi: 10.1002/pd.96
- Issue published online: 18 MAY 2001
- Article first published online: 18 MAY 2001
- Manuscript Accepted: 19 FEB 2001
- Manuscript Revised: 5 FEB 2001
- Manuscript Received: 26 OCT 2000
- amniotic fluid
We have evaluated the role of a rapid and radical method of amniodrainage in the treatment of severe twin–twin transfusion. The outcome of 15 patients with severe twin–twin transfusion for which a amniodrainage was performed by means of a vacuum bottle system was compared with the outcome of 15 patients with a similar condition, matched for gestational age at the time of the initial procedure and drained using a standard procedure. In the study group the amniodrainage ended when no amniotic fluid could be aspirated, whereas the women in the standard group were drained with a syringe system and the fluid was removed until the deepest amniotic fluid pool was <8 cm. At the initial procedure, the mean volume of amniotic fluid drained was significantly (p<0.05) higher (3252 vs 2153 ml) and the length of the procedure significantly (p<0.001) shorter (21 vs 41 min) in the study group than in the standard group. The mean post-procedure amniotic fluid index was significantly (p<0.001) smaller (2.9 vs 7.7 cm) after radical amniodrainage than after the standard amniodrainage. The mean number of procedures was significantly (p<0.001) lower (1.5 vs 5.6) in the study group compared to the standard group. In the study group the mean placental thickness increased significantly (p<0.001) from 9 mm before the procedure to 49 mm after, and the overall perinatal survival rate was 80% and the proportion of pregnancies with at least one survivor was 93%. The present data indicate that early, rapid and radical amniodrainage is an effective and low-cost therapy for severe twin–twin transfusion syndrome. Compared to the standard amniodrainage technique it also appears to reduce the need for multiple procedures. Copyright © 2001 John Wiley & Sons, Ltd.