Analysis of maternal and perinatal outcomes in cases with twin-to-twin transfusion syndrome (TTTS).

Başaranoğlu, Serdar; Tunç, Senem Yaman; Turgut, Abdulkadir; Ağaçayak, Elif; Peker, Nurullah; İçen, Mehmet Sait; Yalınkaya, Ahmet

Objective: Our aim was to analyze maternal and perinatal outcomes of the pregnant women with twin-to-twin transfusion syndrome (TTTS) having a complex physiopathology and developed in monochorionic diamniotic pregnant. Methods: In this study, 330 multiple pregnancies who gave birth at our university clinic between July 2008 and December 2013 were reviewed retrospectively. The demographic data, obstetric history, gestational weeks by ultrasonography, chorionicity and amnionicity conditions, treatment and delivery methods and newborn information were obtained from archive records and electronic database of the hospital. TTTS syndrome staging was carried out according to the criteria reported by Quintero et al. (1999). Results: It was found that 13,368 deliveries were carried out in our clinic and 307 of them were twin pregnancies during the period stated. While 196 (63.8%) of the twin pregnancies were dichorionic diamniotic, 99 (32.2%) of them were monochorionic diamniotic and 12 (3.9%) of them were monochorionic monoamniotic. Spontaneous pregnancy was observed in 256 (83.4%) women and pregnancy after assisted reproduction techniques was observed in 51 (16.6%) women. Thirty-one (31.3%) of monochorionic diamniotic pregnancies were complicated with TTTS. When classifying the newborns, receiver fetuses (fetuses with polyhydramnios) were grouped as Fetus-A and donor ones (fetuses with oligohydramnios or those in stuck-twin appearance) were grouped as Fetus-B. The weight of postpartum newborns was 2089±639 g in Fetus-A group, and 1262±489 g in Fetus-B group (p<0.001). Chorionicity and amnionicity determination of monochorionic twin pregnancies should be done at early weeks and patients should be called for their antenatal follow-ups more frequently. During their antenatal follow-ups, they should be recommended to refer to the centers having the experience to manage complications which may develop in case of fetal development differences, amniotic fluid inconsistencies or doubt in their Doppler profiles. The importance of staging in patients developing twin-totwin transfusion syndrome should be acknowledged and it should be remembered that pleasing results are achieved after the treatment in newborns with early stage (stage I-II) TTTS.

FETOFETAL transfusion; MULTIPLE pregnancy; PREGNANT women; POLYHYDRAMNIOS; PERINATAL care; PATHOLOGICAL physiology; PREGNANCY complications; MATERNAL health services

Perinatal Journal / Perinatoloji Dergisi, 2014, Vol 22, Issue 3, p123

1300-5251

Academic Journal

10.2399/prn.14.0223002