[SINGLE UTERINE PUNCTURE THROUGH THE INTERTWIN MEMBRANE IN TWIN PREGNANCY AMNIOCENTESIS: A DESCRIPTIVE STUDY OF OUR 9 YEARS' EXPERIENCE AT "SHAMIR" ("ASSAF HAROFEH") MEDICAL CENTER].

INTRODUCTION

Obstetrics Gynecology Department, "Shamir" ("Assaf Harofeh") Medical Center, Tzrifin There are 2 methods to perform amniocentesis in twin pregnancy. The widespread method is the two-punctures technique (1 for each sac). The other is a single uterine puncture through the intertwin membrane. No method is known to be superior. The main procedure-related complications are increased risk for fetal loss, amniotic fluid leakage and infection. The information regarding complications in twin pregnancy is limited and the method is not described.

OBJECTIVES

To demonstrate whether a single uterine puncture is an acceptable alternative to the double uterine puncture method.

METHODS

A retrospective cohort study of 112 twin pregnancies which underwent amniocentesis by a single operator at "Shamir" ("Assaf Harofeh") Medical Center between the years 2010-2018. We compared a single uterine puncture (intervention group) to a double uterine puncture (control group).

RESULTS

Eighty-six patients (76.7%) underwent a single uterine puncture and 26 (23.3%) underwent a double uterine puncture. Most pregnancies were uncomplicated in both groups (80.2% vs. 76.9% respectively); no statistical difference was seen in any complication. The most common complication was seeking medical help due to bleeding or contraction (12.8% in single puncture group vs 19.2% in double puncture group). PPROM, infection and loss of pregnancy were rare.

CONCLUSIONS

Only a few studies have related to the method of amniocentesis and compared the results of these 2 methods. A single uterine puncture does not bear an increased risk of complications compared to the double puncture.