Abstract | OBJECTIVE: METHODS: 12 patients were diagnosed with TOPS based on ultrasonographic findings. A 20- to 22-gauge spinal needle was used to puncture the membrane between the twins without any attempt at amnioreduction in 9 patients, while the procedure was combined with amnioreductions in 3 patients. RESULTS: Gestational age was 23.1 +/- 3.3 weeks at the time of septostomy and 31.1 +/- 4.4 weeks at delivery. Rapid accumulation of fluid around the 'stuck' fetus occurred in all cases following a single procedure. Three of the 24 fetuses died in utero and 1 died on the fifth day of life, for a combined survival of 83.3%. In the survivors, the septostomy to delivery interval ranged between 0.6 and 13 weeks (mean +/- SD 8.3 +/- 4.8). CONCLUSION: Amniotic septostomy is a promising new method for the management of TOPS and is associated with survival rates that are better than, or comparable to, more invasive modalities. A multicenter trial comparing septostomy to other modalities is warranted.
|
Authors | G R Saade, M A Belfort, D L Berry, T H Bui, L D Montgomery, A Johnson, M O'Day, G L Olson, H Lindholm, L Garoff, K J Moise Jr |
Journal | Fetal diagnosis and therapy
(Fetal Diagn Ther)
1998 Mar-Apr
Vol. 13
Issue 2
Pg. 86-93
ISSN: 1015-3837 [Print] Switzerland |
PMID | 9650653
(Publication Type: Journal Article)
|
Topics |
- Amnion
(surgery)
- Diseases in Twins
- Female
- Fetal Death
- Fetofetal Transfusion
(diagnostic imaging, surgery)
- Gestational Age
- Humans
- Oligohydramnios
(surgery)
- Polyhydramnios
(surgery)
- Pregnancy
- Pregnancy Outcome
- Ultrasonography, Prenatal
|