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Re: OB-GYN-L digest 693From: Michael A. Belfort (mbelfort@bcm.tmc.edu)Tue Oct 29 08:40:20 1996
The concept of deliberately making a window between the two sacs in twin-oligo-poly Syndrome (TOPS) was, to my knowledge, first suggested by Dr. George Saade while he was at Baylor College of Medicine. He has now moved on to UTMB in Galveston but continues to enlarge his experience in this field. We did the first 3 cases at Baylor and George presented this work at the SPO about 2 years ago. He theorised that the poly sac flattens the oligo sac against the uterine wall and that in certain circumstances performing an amnio actually punctures both sacs and allows communication between the two sacs. We have literally watched the oligo sac equalise with the poly sac in about 30 to 60 minutes. The fact that the two sacs equalise is not really the issue if the outcome remained the same. However, as clinical experience mounts, it is becoming evident that survival rates of both twins appear to be superior to many of the other methods being used. George is collecting cases to publish I am sure he would be happy to collaborate with those doing this procedure so that the combined international experience can be published. His original manuscript was declined publication on the basis that too few cases were described to substantiate his claims. I think that with a collaborative effort we can remedy this. His address is: Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas USA. Regards
-- Michael A. Belfort, MD
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