STUCK TWIN SYNDROME - OUTCOME IN 37 CONSECUTIVE CASES

OBJECTIVE: Our purpose was to further evaluate the role of serial amni ocentesis in pregnancies complicated by the ''stuck twin'' syndrome. S TUDY DESIGN: A cohort of 37 consecutive cases of stuck twin syndrome w as followed up from 1986 through 1992. Evaluations included gestationa l age at diagnosis and at delivery, mean number of amniocenteses, volu me of amniotic fluid withdrawn, placentation, perinatal complications, fetal survival, and neonatal follow-up. RESULTS: Five pregnancies wer e terminated, five had no intervention, and 27 underwent serial amnioc enteses. The mean number of amniocenteses was 3.4 (range 1 to 6), and mean total amniotic fluid volume withdrawn was 5.8 L (range 0.75 to 4. 0). In the serial amniocentesis group mean gestational age was 23.1 we eks (range 16 to 30) at diagnosis and 31.5 weeks (range 20 to 38) at d elivery. Eighty-two percent had monochorionic placentas, and 36% had m arginal or velamentous cord insertions. Infant survival was 39 of 54 ( 74%) in the serial amniocentesis group compared with four of 10 (40%) in the nonintervention group (relative risk 0.46, 95% confidence inter val 0.24 to 0.90). CONCLUSION: Serial amniocentesis was associated wit h a 54% reduction in fetal and neonatal death in cases of stuck twin s yndrome.