Outcome of Pregnancies Complicated by Twin-Twin Transfusion Syndrome in King Chulalongkorn Memorial Hospital
Suksan Korpraphong MD*, Somchai Tanawattanacharoen MD*
Affiliation : * Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand
Objective : To study perinatal outcomes of pregnancies complicated by twin-twin transfusion syndrome (TTTS), which were
treated with the authors’ intervention modalities. Maternal outcomes of these populations were also explored.
Material and Method: All pregnancies diagnosed TTTS that delivered in King Chulalongkorn Memorial Hospital between
January 2000 and November 2009 were enrolled in this descriptive study. Patients’ data before August 2008 were retrospectively
assessed. Perinatal survival, neonatal morbidities, and maternal outcomes were recorded and analyzed. Antenatal
ultrasonographic findings were also analyzed to determine prognostic factors on perinatal outcomes.
Results : Twenty-five cases of TTTS were recruited in the present study. Overall perinatal survival was 58% (29/50) with no
significant difference in perinatal in among various stages of disease (p = 0.19). Survival in stage I-II, stage III, and stage IV
were 64.3%, 45.8%, and 75%, respectively. There was no maternal mortality in the present study. The most common
maternal morbidity was preeclampsia (6/25; 24%). Progression of disease was the only significant prognostic factor for
perinatal mortality (p < 0.001).
Conclusion : Overall perinatal mortality rate of TTTS in the presented populations was still high (42%). Progression of
disease was the only significant prognostic factor for poor perinatal outcome in the preset study. Since the case number of the
present study was too small, the conclusion that the prognosis of the conservatively treated TTTS was unrelated to the staging
cannot be drawn.
Keywords : Twin-twin transfusion syndrome, Perinatal outcomes, Amnioreduction, Prognostic factors
