Transient amniotic fluid leakage after fetoscopic laser photocoagulation for twin-twin transfusion syndrome

Aim Iatrogenic premature ruptureof membrane( PROM) is one of the major complications related to fetoscopiclaser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). However, amniotic fluid leakage (AFL) sometimes spontaneously disappears. This study evaluated the incidence and clinical characteristics of transient AFL after FLP. Methods We retrospectively reviewed pregnancies that underwent FLP for TTTS at a single center. Patients with apparent AFL within 2 weeks after FLP were divided into two groups: transient AFL, defined by the disappearance of fluid leakage within a week; and PROM, if AFL persisted continuously for more than a week or premature birthoccurred, including miscarriage, within a week of the first symptom of AFL. Results Among 201 monochorionic twinpregnancies that underwent FLP during the study period, nine patients (4.5%) were diagnosed with AFL within a week after FLP. Four patients (2.0%) were classified as transient AFL and five as PROM. Median gestational age at FLP was not significantly different between the groups; operative time in the PROMgroup was significantly longer (P = 0.01). The surgery to delivery interval and median gestational age at delivery were greater in the transient AFL group (87.8 vs 17.6 days, P = 0.01; 32.5 vs 23.6 weeks, P = 0.01, respectively). Conclusions The incidence of transient AFL after FLP was 2%. Perinatal outcomes of transient AFL might be better than that of PROM.