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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

REFERENCES

1. Arvis, PH, Rose, JM, Priou, B, Fraisse, E, Grall, J (1983): Hydramnios aiger et grossesse gemellaire. L Gyn Obst Briol Rep 12:283–286.Google Scholar
2. Bender, S (1952): Twin pregnancy; review of 472 cases. J Obstet Gynecol Br Emp 59:510–517.Google Scholar
3. Benirschke, K, Driscoll, SG (1967): The pathology of the human placenta. New York: Springer-Verlag.Google Scholar
4. Benirschke, K (1984): Multiple gestation, incidence etiology and inheritance. In Creasy, RK, Resmik, R (eds): Maternal Fetal Medicine. Philadelphia, London, Toronto: W.B. Saunders Company, pp 519–520.Google Scholar
5. Brennan, JN, Diwan, RV (1982): Fetofetal transfusion syndrome: prenatal ultrasonographic diagnosis. Radiology 143:535–536.Google Scholar
6. Brown, GR, Macaskill, S (1961): Acute hydramnios with twins successfully treated by abdominal paraceatesis. Br Med J 1:1739–1740.CrossRefGoogle Scholar
7. Brown, GR (1980): Letter to the editor. Br J Obstet Gynecol 87:255.CrossRefGoogle Scholar
8. D'Alton, ME, Jilson, AE, How, S, Newton, ER, Feingold, M, Cetrulo, CL: Treatment of premature labor with calcium antagonist Nifedipine – A preliminary report. Accepted for publication in Am J Obst Gynecol.Google Scholar
9. Erskin, JP (1944): Amniocentesis in the treatment of polyhydramnios in a twin pregnancy. J Obstet Gynecol Br Emp 51:549–551.Google Scholar
10. Mills, WG (1980): Letter to the editor. Br J Obstet Gynecol 87:256.Google Scholar
11. Pritchard, JA, Mason, R, Corley, M, Pritchard, S (1970): Genesis of severe placental abruption. Am J Obstet Gynecol 108:22–25.CrossRefGoogle ScholarPubMed
12. Queenan, JT, Gadow, EC (1970): Polyhydramnios chronic versus acute.Am J Obstet Gynecol 108:349–355.CrossRefGoogle Scholar
13. Walker, E (1985): Personal communication.Google Scholar
14. Weir, PE, Ratten, GJ, Beischer, NA (1979): Acute polyhydramnios – A complication of monozygous twin pregnancy. Br J Obstet Gynecol 86:849–852.Google Scholar
15. Wittman, BK, Baldwin, VJ, Nichol, B (1981): Antenatal diagnosis of twin transfusion syndrome by ultrasound. Obstet Gynecol 58:123–127.Google Scholar