Twins twin transfusion syndrome in monochorionic twins
- International Journal of Pregnancy & Child Birth
Mohamed W Gawish, AAAl Ibrahim, Sawsan Al Obaidly, Mohamed Ali Mustafa Khalil, Mohamed Ahmed Abdelmoneam Ramadan
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Objective: To report our experience with the Monochorionic Diamniotic pregnancies complicated by Twin-Twin Transfusion Syndrome (TTTS) in a large retrospective cohort study. It emphasizes on the clinical prognostic implication of TTTS, the importance of timely surveillance and intervention in an attempt to prevent the increased fetal/perinatal morbidity and mortality.
Materials and methods: This retrospective study was conducted at Women’s Hospital, Hamad Medical Corporation, Qatar (2003-Oct.2014) including all the Monochorionic Diamniotic twins who were complicated by TTTS. The data included the maternal biodata, method of conception and maternal complications, ultrasound findings and follow-ups, intervention (if any), delivery gestational age was as well as the birth/miscarriage data, and birth weight. We kept these data anonymously in a password protected Excel sheet and the analysis carried using online statistics tools.
Results: 18 cases of TTTs diagnosed among 206 Monochorionic diamniotic twin (8.7%), The mean gestational age at diagnosis is 23±4 weeks. 39% had an advanced TTTS (stage 3, 4 and 5). Mean maternal age was 29.5±4.9 years, versus 30.2±5.7 years of No-TTTS cases (p-value 0.6). The rate of miscarriage was 28% and IUFD was 27%, the mean diagnosis-IUFD interval was 1.6±1.6 weeks. The mean gestation age at delivery was 27.2±4.6 weeks versus 30.2±5.7 weeks for the Non-TTTS (p-value 0.0001). The mean birth weight for the alive recipients after 24 weeks was 1364±564 grams versus 907.6±289.9 for the donor (p-value 0.04).
Conclusion: Our research highlights the continuous devastating complications of monochorionic twins. It is our duty as health professionals to provide a comprehensive counselling as early as chorionicity regarding these risks and their implications on the mother and fetus/neonate.
twins twin transfusion, diabetes, birth weight, pregnancies, chorionicity, fetus, hydrops