Therapeutic amniocentesis for treatment of twin-twin transfusion syndrome.
The objective was to determine whether therapeutic amniocentesis may improve outcomes in patients with twin-twin transfusion syndrome. Eleven patients were managed aggressively with repetitive serial amniocenteses, and six patients were managed conservatively. The time interval between diagnosis and delivery was 17.4 days more in the amniodrainage group, but the difference between the groups was not significant (68.3+/-41.9 days in the therapeutic amniocentesis group and 50.83+/-29.7 days in the expectant management group [p=0.384]). The overall survival rate of the two groups was 38.2%, and was not significantly different between groups (40.9% in the amniocentesis group and 33.3% in the expectant management group; p=1.00). Two of nine (22.2%) infants in the amnioreduction group, and one of four (25.0%) infants in the expectantly managed group had neurological symptoms. Our results did not show a significant benefit of aggressive therapeutic amniocentesis. A slight improvement in perinatal outcome was observed.