ABSTRACT
We retrospectively studied 10 cases of twin-to-twin transfusion syndrome (TTTS) with fetal hydrops. TTTS was diagnosed sonographically between the 17-31 weeks of gestation. All twins were delivered by emergency cesarean section because of cardiac decompensation of one or both fetuses. The mean (±SD) age at diagnosis was 26.1 ± 4.5 and the mean age at delivery was 28.8 ± 2.0 weeks. Gestational age at birth was similar in survivors and nonsurvivors. However, surviving infants were diagnosed later in gestation (23.6 ± 4.8 vs. 28.7 ± 1.9 weeks; p < 0.01); and gestational age at appearance of hydrops were later in survivors (26.1 ± 3.2 vs. 29.2 ± 2.4 weeks; p < 0.05). Overall survival rate was 50% (10 of 20 infants). All survivors were delivered within 3 days after the appearance of fetal hydropic changes. Extrauterine treatment in earlier stages of TTTS might improve the outcome. Nevertheless, more aggressive in-trauterine treatment should be considered in the most severe cases of TTTS developing before 24-25 weeks' gestation.
Keywords
Twin-to-twin transfusion syndrome - Hydrops fetalis - intrauterine treatment
