Amniotic septostomy for the treatment of twin oligohydramnios-polyhydramnios sequence

George Saade, Michael A. Belforf, David L. Berry, The Hung Bui, Lynn D. Montgomery, Anthony Johnson, Mary O'Day, Gayle Olson, Henry Lindholm, Leena Garoff, Kenneth J. Moise

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Objective: To report our experience with intentional puncture of the intervening membrane ('septostomy') for the treatment of the twin oligohydramnios-polyhydramnios sequence (TOPS). Methods: 12 patients were diagnosed with TOPS based on ultrasonographic findings. A 20- to 22-gauge spinal needle was used to puncture the membrane between the twins without any attempt at amnioreduction in 9 patients, while the procedure was combined with amnioreductions in 3 patients. Results: Gestational age was 23.1 ± 3.3 weeks at the time of septostomy and 31.1 ± 4.4 weeks at delivery. Rapid accumulation of fluid around the 'stuck' fetus occurred in all cases following a single procedure. Three of the 24 fetuses died in utero and 1 died on the fifth day of life, for a combined survival of 83.3%. In the survivors, the septostomy to delivery interval ranged between 0.6 and 13 weeks (mean ± SD 8.3 ± 4.8). Conclusion: Amniotic septostomy is a promising new method for the management of TOPS and is associated with survival rates that are better than, or comparable to, more invasive modalities. A multicenter trial comparing septostomy to other modalities is warranted.

Original languageEnglish (US)
Pages (from-to)86-93
Number of pages8
JournalFetal Diagnosis and Therapy
Volume13
Issue number2
DOIs
StatePublished - 1998

Fingerprint

Oligohydramnios
Polyhydramnios
Punctures
Fetus
Membranes
Therapeutics
Gestational Age
Multicenter Studies
Needles
Survivors
Survival Rate
Survival

Keywords

  • Amniocentesis
  • Feta-fetal transfusion
  • Septostomy
  • Stuck twin
  • Twin oligohydramnios-polyhydramnios sequence, treatment
  • Twin-twin transfusion

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Saade, G., Belforf, M. A., Berry, D. L., Bui, T. H., Montgomery, L. D., Johnson, A., ... Moise, K. J. (1998). Amniotic septostomy for the treatment of twin oligohydramnios-polyhydramnios sequence. Fetal Diagnosis and Therapy, 13(2), 86-93. https://doi.org/10.1159/000020812

Amniotic septostomy for the treatment of twin oligohydramnios-polyhydramnios sequence. / Saade, George; Belforf, Michael A.; Berry, David L.; Bui, The Hung; Montgomery, Lynn D.; Johnson, Anthony; O'Day, Mary; Olson, Gayle; Lindholm, Henry; Garoff, Leena; Moise, Kenneth J.

In: Fetal Diagnosis and Therapy, Vol. 13, No. 2, 1998, p. 86-93.

Research output: Contribution to journalArticle

Saade, G, Belforf, MA, Berry, DL, Bui, TH, Montgomery, LD, Johnson, A, O'Day, M, Olson, G, Lindholm, H, Garoff, L & Moise, KJ 1998, 'Amniotic septostomy for the treatment of twin oligohydramnios-polyhydramnios sequence', Fetal Diagnosis and Therapy, vol. 13, no. 2, pp. 86-93. https://doi.org/10.1159/000020812
Saade, George ; Belforf, Michael A. ; Berry, David L. ; Bui, The Hung ; Montgomery, Lynn D. ; Johnson, Anthony ; O'Day, Mary ; Olson, Gayle ; Lindholm, Henry ; Garoff, Leena ; Moise, Kenneth J. / Amniotic septostomy for the treatment of twin oligohydramnios-polyhydramnios sequence. In: Fetal Diagnosis and Therapy. 1998 ; Vol. 13, No. 2. pp. 86-93.
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