Serial amniocentesis
Serial amniocentesis could also be called amnioreduction.
The goal of this therapy is to decrease the
likelihood of miscarriage or preterm labor by reducing
the amniotic fluid volume in the sac of the
recipient twin [6]. There is no standard technique
for performing serial amniocentesis. How much fluid
should be removed, at what rate, what needle, or
what type of anesthesia should be used are among
the issues that could benefit from standardization [6].
In Chang Gung Memorial Hospital, we only perform
serial amniocentesis in cases of TTTS with gestational
age ≥ 27 weeks. The patients treated by serial amniocentesis
before this have been reported to have had
14% cases of leukomalacia in the surviving fetuses
and 76% risk of death of both fetuses [14]. So amnioreduction
is not considered as the first line of therapy
for TTTS diagnosed before 26 weeks of gestation.
Sonography is very important in the procedure of
amnioreduction, because you need to evaluate the