EP10.08: Adverse outcomes in monochorionic twins with amniotic fluid abnormalities without Twin–twin transfusion syndrome

This study aimed to describe amniotic fluid abnormalities in monochorionic diamniotic (MCDA) twins not meeting criteria for Twin–twin transfusion syndrome (TTTS). This case-control study reviewed MCDA twins between 2018-2022 at a tertiary fetal centre. Twins with normal imaging comprised a control group. Cases with fluid abnormalities were divided into 4 subgroups: polyhydramnios or oligohydramnios of one twin, selective fetal growth restriction (sFGR) with fluid abnormality, and subjective provider concern. Twins with clear diagnostic findings of TTTS, sFGR, or twin anemia-polycythemia sequence (TAPS) were excluded, as were fetal anomalies affecting fluid, higher order gestation, and cases with only 1 scan. Of 737 twins, 300 were excluded for clear diagnoses, 19 for fetal anomaly, 10 for higher order multiples, and 44 for only one scan. Of the remaining 364, 224 were controls, while 140 cases had fluid abnormalities not diagnostic for TTTS. Cases had more TTTS (41%), TAPS (8%), new-onset sFGR (11%), need for laser (36%, all p < 0.001), fetal demise (11% vs 1%, p < 0.001) and maternal admission (15% vs 4% p = 0.001). Cases also had an earlier deliveries (33.1 vs 35.1 wk, p < 0.001). Time to laser or delivery is presented in tabular and survival curve format (see figure 1). Amniotic fluid abnormalities not meeting TTTS criteria involve more complications, fetal intervention, fetal demise, and long hospital stays. Such cases often declare themselves within 4 weeks. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.