Am J Obstet Gynecol. 2000 Mar;182(3):706-12.
Obstetric and perinatal outcomes from the Australian and New Zealand twin-twin transfusion syndrome registry.
Dickinson JE, Evans SF.
Department of Obstetrics and Gynaecology,
University of Western Australia, Australia.
Our purpose was to investigate the antepartum characteristics and perinatal outcomes of twin-twin transfusion syndrome cases from a multicenter
Perinatal centers in Australia and New Zealand voluntarily notified a central evaluation registry with information on identified pregnancies with twin-twin transfusion syndrome during 1995 through 1998.
One hundred twelve cases of twin-twin transfusion syndrome were registered. The median gestation at diagnosis was 21.5 weeks (range, 14.4-34.6 weeks). Oligohydramnios-polyhydramnios sequence was the most common presentation, with 84% of cases involving "stuck" twinning. Therapeutic amnioreduction was used in 92 cases (82.1%), with the median number of procedures per case being 2 (range, 1-23). The median gestation at delivery was 29 weeks (range, 18-38 weeks). The overall perinatal
survival rate was 62.5%. Abnormal findings on
cranial ultrasonography were present in 27.3%
of live neonates, and periventricular leukomalacia
was reported in 10.8%. Increased gestational
age at delivery, the presence of umbilical artery diastolic flow, and a prolonged interval from final
amnioreduction to delivery were positively
associated with the delivery of live fetuses without complications.
The majority of antenatally identified cases of
twin-twin transfusion syndrome are managed with
serial amnioreduction. Despite contemporary
obstetric and neonatal management strategies,
perinatal mortality and morbidity rates are high.
PMID: 10739534 [PubMed - indexed for MEDLINE]