[SINGLE UTERINE PUNCTURE THROUGH THE INTERTWIN MEMBRANE IN TWIN PREGNANCY AMNIOCENTESIS: A DESCRIPTIVE STUDY OF OUR 9 YEARS' EXPERIENCE AT "SHAMIR" ("ASSAF HAROFEH") MEDICAL CENTER].

Introduction: Obstetrics Gynecology Department, "Shamir" ("Assaf Harofeh") Medical Center, Tzrifin There are 2 methods to perform amniocentesis in twin pregnancy. The widespread method is the two-punctures technique (1 for each sac). The other is a single uterine puncture through the intertwin membrane. No method is known to be superior. The main procedure-related complications are increased risk for fetal loss, amniotic fluid leakage and infection. The information regarding complications in twin pregnancy is limited and the method is not described.

Objectives: To demonstrate whether a single uterine puncture is an acceptable alternative to the double uterine puncture method.

Methods: A retrospective cohort study of 112 twin pregnancies which underwent amniocentesis by a single operator at "Shamir" ("Assaf Harofeh") Medical Center between the years 2010-2018. We compared a single uterine puncture (intervention group) to a double uterine puncture (control group).

Results: Eighty-six patients (76.7%) underwent a single uterine puncture and 26 (23.3%) underwent a double uterine puncture. Most pregnancies were uncomplicated in both groups (80.2% vs. 76.9% respectively); no statistical difference was seen in any complication. The most common complication was seeking medical help due to bleeding or contraction (12.8% in single puncture group vs 19.2% in double puncture group). PPROM, infection and loss of pregnancy were rare.

Conclusions: Only a few studies have related to the method of amniocentesis and compared the results of these 2 methods. A single uterine puncture does not bear an increased risk of complications compared to the double puncture.