Conclusion
The controlled AR procedure based on simultaneous measurement of the
amniotic pressure and the removed fluid has been developed. Analysis of
the descending amniotic pressure as the removed amniotic fluid volume
increases revealed exponential decay with a final plateau for the first
time. This asymptotic pattern indicates that removing additional volumes
would have a negligible effect on the amniotic pressure. Accordingly,
monitoring the amniotic pressure may be more effective for the therapy
management rather than estimation of drained fluid volume. Moreover, the
final plateau of the amniotic pressure could serve as a diagnostic
criterion for procedure termination. The efficiency of this new
methodology has the potential to increase survival rates and wellness of
both TTTS fetuses. Furthermore, the controlled AR is a simple,
non-sophisticated procedure that does not require complicated or
expensive equipment and special training.
Disclosure of interests: the authors have no conflicts of
interest