Iatrogenic Monoamniotic Twin Gestation with Progressive Twin-Twin Transfusion Syndrome

Abstract
Objective: Intentional puncture of the membrane has been reported to be a promising new method for the management of twin-twin transfusion syndrome. Case Report: Treatment of twin-twin transfusion syndrome with serial amniocenteses resulted in unintentional puncture of the dividing membrane at 24 weeks of gestation. Fetal growth discordance increased, and twin-twin transfusion did not improve following the puncture. Intrauterine death of both fetuses at 27 weeks of gestation occurred. Conclusion: Amniotic septostomy for the treatment of twin-twin transfusion sydnrome should be performed with serious consideration.

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