Fetal outcome of twenty cases of "Stuck " twin syndrome

Özet

Bu çalışmadaki amaç, 20 "stuck" ikiz olgusunun fetal sonuçlarını değerlendirmektir. Yedi olguya amniodrenaj uygulandı, 13 olgu müdahalesiz izlendi. Yirmi olgunun 18'i monokorionik ve aynı zamanda ikizden ikize transfüzyon sendromu olup, diğer iki olgu ise monokorionik ve dikorionik "discordant" ikiz olarak değerlendirildi. Yirmisekizinci haftadan önce amniodrenaj ve izlem yapılan hastalarda perinatal yaşam oranı sırasıyla 2/10 ve 0/14, Yirmi sekiz gebelik haftasından sonra ise amnidrenaj ve izlem grubunda perinatal yaşam oranı sırasıyla 4/4 ve 10/12 olarak bulundu.

Abstract

OBJECTIVE: The purpose of this study is to evaluate the fetal outcome of pregnancies complicated by the stuck twin syndrome. STUDY DESIGN: Twenty conecutive cases of suck twin syndrome were followed up from January 1999 to May 2002. Evaluation included gestaional age at diagnosis and delivery, mean number of amniocentesis, volume of amniotic fluid withdrawn, placentation, fetal survival rate and postnatal follow-up. RESULTS: Eighteen cases of 20 stuck twin pregnancies were monochorionic and twin-twin transfusion syndrome, the other two cases were monochorionic and dichorionic discordant twins. Seven pregnancies had amniodreange and mean amniocentesis was three times with average revomal of 2200 ml amniotic fluid (range;1500-3000ml). Thirteen cases had no intervention. Ten cases without intervention and one case in amniodrenage group had premature uterine contraction. After 28 weeks all delivered at least one live birth. Before 28 weeks all of expectant group and four of five cases of amniodrenage group aborted. Survival rate before 28 weeks was 2/10 in amniodrenage group and was 0/14 in follow-up group. After 28 weeks, survival rate of amniodrenage and expectant group was 4/4 and 10/12 respectively. CONCLUSION: Perinatal mortality rate of stuck twin syndrome is vey high if it develops before 28 weeks and presented with pramature uterine contraciton.