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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.
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=
Retrieve&db=
PubMed&list_uids=10739534&dopt=Abstract
Dickinson JE, Evans SF.

Department of Obstetrics and Gynaecology,
University of Western Australia, Australia.

OBJECTIVE:
Our purpose was to investigate the antepartum characteristics and perinatal outcomes of twin-twin transfusion syndrome cases from a multicenter
national registry.

STUDY DESIGN:
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.

RESULTS:
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.

CONCLUSION:
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]

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