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KMID : 0358420110540080413
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Korean Journal of Obstetrics and Gynecology
2011 Volume.54 No. 8 p.413 ~ p.419
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The perinatal outcomes of twin-to-twin transfusion syndrome for 10 years’ experiences (2000-2009)
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Park Han-Na
Hwang Sun-A
Seo Ji-Sun
Jun Seung-Ju
Lee Ji-Won
Kim Seok-Yong
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Abstract
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Objective: Twin-to-twin transfusion syndrome (TTTS) is the most serious complication in monochorionic twin. We investigated the stage and prognosis of pregnant women who diagnosed as TTTS at our institution for 10 years.
Methods: Between 2000 and 2009, 476 twins (312 dichorionic twins, 164 monochorionic twins) were born in our hospital. We reported the perinatal outcomes for 27 cases of TTTS (16% of monochorionic twins), which were classified by Quintero’s clinical staging. Stage was decided at the time of initial examination by ultrasound. We examined placentas of all cases after delivery and confirmed the exact chorionicity. In total 20 cases, amnioreduction were performed and 8 cases (16 baby) were followed.
Results: There were 8 cases of stage I, 2 case of stage II, 3 case of stage III, 4 cases of stage IV, and 10 cases of stage V. There was significant difference of the time period between diagnosis and birth in early stage of TTTS. In cases in which both fetuses survived, time period between diagnosis and birth, and pregnancy duration were significantly longer than other one fetus survived or both twin death cases. Amnioreduction was performed in 20 cases for the treatment of TTTS and 60% of mean survival rates of neonate were shown. There were 86% of survival rate in stage I-III, 27% in stage IV-V. Only one baby developed neurological sequelae after amnioreduction.
Conclusion: Early diagnosis of TTTS and aggressive amnioreduction may improve the fetal survival rate.
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KEYWORD
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Twin twin transfusion syndrome, Amnioreduction, Survival rate
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