Fetal and neonatal outcomes in twin oligohydramnios-polyhydramnios sequence including cerebral palsy.

OBJECTIVE

The purpose of this study was to review consecutive pregnancies complicated by twin oligohydramnios-polyhydramnios sequence (TOPS) and to clarify the probable factors influencing the perinatal outcomes.

METHODS

Twenty-five pregnancies with a diagnosis of TOPS were treated with and without amniocentesis. A poor perinatal outcome was defined when either perinatal mortality or cerebral palsy was observed.

RESULTS

The mean gestational age at the time of diagnosis and of delivery was 27.8 (range 21-34) and 30.7 (range 23-35) weeks, respectively. Tocolytic therapy and therapeutic amniocentesis were done in 16 (64%) and 13 (52%) cases. Hydrops fetalis was present in 10 cases. The survival rate was 72%, and cerebral palsy was diagnosed in 8 of 36 infants (22%). The poor prognostic factors were gestational age at delivery (<30 weeks) and presence of symptomatic preterm labor and hydrops fetalis. Therapeutic amniocentesis did not influence the perinatal outcome.

CONCLUSIONS

In this observational study, the long-term as well as the short-term perinatal outcome of pregnancy with TOPS seems to be poor. In addition, therapeutic amniocentesis in TOPS does not appear to affect fetal and neonatal outcomes.