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Serial Amniocenteses in the Treatment of Twin to Twin Transfusion Complicated with Acute Polyhydramnios

Published online by Cambridge University Press:  01 August 2014

M. Feingold ,
C.L. Cetrulo ,
E.R. Newton ,
J. Weiss ,
C. Shakr  and
S. Shmoys
M. Feingold*
Affiliation:
Department of Maternal-Fetal-Medicine, Tufts Affiliated Hospitals, St. Margaret's Hospital for Women, Boston
C.L. Cetrulo
Affiliation:
Department of Maternal-Fetal-Medicine, Tufts Affiliated Hospitals, St. Margaret's Hospital for Women, Boston
E.R. Newton
Affiliation:
Department of Maternal-Fetal-Medicine, Tufts Affiliated Hospitals, St. Margaret's Hospital for Women, Boston
J. Weiss
Affiliation:
Department of Maternal-Fetal-Medicine, Tufts Affiliated Hospitals, St. Margaret's Hospital for Women, Boston
C. Shakr
Affiliation:
Department of Maternal-Fetal-Medicine, Tufts Affiliated Hospitals, St. Margaret's Hospital for Women, Boston
S. Shmoys
Affiliation:
Department of Maternal-Fetal-Medicine, Tufts Affiliated Hospitals, St. Margaret's Hospital for Women, Boston
*
St. Margaret's Hospital for Women, 90 Cushing Avenue, Boston, MA 02125, USA

Abstract

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Twin to twin transfusion, complicated by acute polyhydramnios in a monozygous twin pregnancy, is a difficult clinical problem. A precipitous course usually results in termination of the pregnancy within a few days and often is associated with a high perinatal mortality rate. Two cases are presented that were treated with repeated amniocenteses for the relief of extreme abdominal discomfort and to prevent imminent premature labor. The amount of amniotic fluid removed each time varied from 300 cc to 1200 cc, which was enough to relieve symptoms but not enough to induce uncontrolled uterine activity. A total of 3500 cc and 4750 cc of amniotic fluid were removed from the first and the second patient, respectively. The procedure was found to be safe and resulted in prolonging the pregnancies by 14 and 11 days, respectively. This management, with the addition of tocolysis and close fetal surveillance can offer some hope in an otherwise hopeless situation.

Keywords

Serial amniocentesisTwin to twin transfusionPolyhydramnios –acuteMonozygous twin pregnancy
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 35 , Issue 1-2 , April 1986 , pp. 107 - 113
Copyright
Copyright © The International Society for Twin Studies 1986

References

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