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