Amniopatch as a treatment for rupture of membranes following laser surgery for twin-twin transfusion syndrome

Fetal Diagn Ther. 2010;27(3):134-7. doi: 10.1159/000275685. Epub 2010 Jan 13.

Abstract

Objective: The risk of iatrogenic rupture of membranes (IROM) is 5-30% after operative fetoscopy. The aim of this study was to describe outcomes of patients with IROM following selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome (TTTS) who were subsequently treated with amniopatch therapy.

Methods: A review of patients who underwent treatment for mid-trimester TTTS between March 2006 and February 2008 with IROM within 7 days of SLPCV was performed. IROM patients without evidence of preterm labor or chorioamnionitis were offered expectant management, pregnancy termination, or amniopatch therapy.

Results: Ninety-three patients were treated with SLPCV, of which three (3.2%) had IROM within 7 days. All three opted for amniopatch therapy which was performed at 18 2/7, 23 1/7, and 22 6/7 weeks' gestation in patients 1, 2 and 3, respectively. In patients 1 and 2, amniopatch therapy sealed membranes within 7 days. A second amniopatch was required for patient 3 before IROM resolved. Gestational ages at delivery were 38 2/7, 37 5/7 and 30 2/7 weeks, respectively.

Conclusion: Amniopatch is a viable treatment option for iatrogenic ROM following SLPCV.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fetal Membranes, Premature Rupture / etiology
  • Fetal Membranes, Premature Rupture / therapy*
  • Fetofetal Transfusion / surgery*
  • Fetoscopy / adverse effects
  • Humans
  • Iatrogenic Disease
  • Laser Coagulation / adverse effects*
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, Second
  • Retrospective Studies
  • Treatment Outcome