IATROGENIC MONOAMNIOTIC TWINS AS A COMPLICATION OF THERAPEUTIC AMNIOCENTESIS

Background: Therapeutic amniocentesis has been accepted widely as a sa fe and efficacious way to treat the polyhydramnios-oligohydramnios seq uence associated with twin-twin transfusion syndrome. Case: A 28-year- old woman, gravida 2, para 1, diagnosed with twin-twin transfusion syn drome at 28 weeks' gestation was treated with serial amniocenteses. Th e dividing membrane was ruptured inadvertently during therapeutic amni ocentesis, with subsequent complete disruption of the amniotic membran e. Iatrogenic monoamniotic twins with cord entanglement and knotting r esulted. Conclusion: Creation of monoamniotic twins by disruption of t he dividing membrane can be a complication of therapeutic amniocentesi s for twin-twin transfusion syndrome. Such disruption may result in th e same morbidity and mortality that are seen in naturally occurring mo noamniotic twins. (C) 1998 by The American College of Obstetricians an d Gynecologists.