Amnioreduction in stage I twin-to-twin transfusion syndrome
A. V. Mikhailov , A. N. Romanovsky , T. A. Kashtanova , A. V. Novikova , A. V. Shlykova , S. A. Potanin , A. A. Kuznetsov
Bulletin of the Russian Military Medical Academy ›› 2017, Vol. 19 ›› Issue (1) : 82 -84.
Amnioreduction in stage I twin-to-twin transfusion syndrome
It has been considered successful application of a single fetus amnioreduction to correct stage I of feto-fetal transfusion syndrome during pregnancy 29 weeks and 6 days. During the follow-up a positive dynamics of the amniotic fluid quantity and the fetal growth was observed. The patient was delivered by elective caesarean section due to the development of labor at 33 weeks and 6 days of gestation. The weight of the recipient twin was 2300 g, the donor twin – 2000 g. Apgar score in both fetuses was 7/8. This case clearly demonstrates the feasibility of effective correction of early stage twin-to-twin transfusion syndrome by amnioreduction, which managed to prolong pregnancy for 4 weeks and 6 days, achieving greater morphological and functional fetal maturity and birth weight over 2000 g in both fetuses. Observation confirms the modern concept that early stage of twin-to-twin transfusion syndrome in the third trimester of pregnancy in the absence of progression does not require urgent delivery. It was the interest observation of twin anemia polycythemia syndrome development on a background of chronic twin-to-twin transfusion syndrome. In scientific literature of the last years there are lack of observations concerning an acute syndrome and a syndrome of anemia polycythemia development in labour. Also, currently there is no uniform scientifically based point of view, regarding the timing of the planned delivery in of feto-fetal syndrome without a laser coagulation of anastomoses of the placenta. Using of amnioreduction in twin-to-twin transfusion syndrome still the treatment option of the choice at early stages, but future researches for optimization of stage I management are still required.
monochorionic twins / twin-to-twin transfusion syndrome / arteriovenous placental anastomoses / fetoscopic selective laser coagulation / pregnancy outcomes / amnioreduction / antenatal fetal death / twin anaemia-polycythaemia syndrome
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