Results
The 11 patients recruited for this study underwent 18 controlled AR
procedures due to severe TTTS. The choice of AR treatment instead of FLA
was done by the mother. There were no cases of maternal infection or
complications as well as premature delivery in the upcoming 48 hours
passed the procedure. Clinical and perinatal outcome characteristics of
the study population are presented in Table 1.
Ten of 11 TTTS cases were categorized as Quintero stage III (91%). The
gestational age at the first AR treatment ranged from 17 to 32 weeks,
with a mean age of 26.8 weeks. The amniotic fluid volume removed during
a single session varied between 700-4500 ml. The time required to
perform the procedure ranged from 20 minutes to more than two hours, in
accordance with the drained volume. Five patients (45.5%) were treated
with the serial controlled AR. Thus, the number of amniocenteses ranges
from one to four per pregnancy (mean 1.6), in a median interval of 14.5
days. In all cases births were premature with delivery at 28 to 35
gestational weeks. The mean donor weight was 1185±470g and the mean
recipient weight was 1566±547g. Nine out of 11 twin pairs were born
alive. The outcomes in the other 2 pregnancies were as follows: a
spontaneous delivery at week 35 with one surviving twin and the other
macerated stillbirth, and a late abortion in week 22 with intrauterine
death of one fetus and the co-twin died soon after birth. Therefore, the
total survival rate was 19 out of 22 twins (86.4%).