Septostomy with or without amnioreduction for the treatment of twin-to-twin transfusion syndrome

Summary

The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on septostomy with or without amnioreduction for the treatment of twin-to-twin transfusion syndrome in December 2006. In accordance with the Interventional Procedures Programme Process Guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in December 2009 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.

Description

Twin-to-twin transfusion syndrome occurs when unborn identical twins have different sacs in the womb but share the same placenta. This results in blood flow from one twin to the other through connections between blood vessels in the shared placenta becoming unbalanced. The volume of fluid around the twins also becomes uneven. In septostomy with or without amnioreduction, a needle is used to make a hole in the membrane separating the twins to even out the volume of the fluid surrounding the babies. Sometimes excess amniotic fluid may need to be removed with another needle (this procedure is called amnioreduction).

OPCS4.6 Code(s):

R08.8 Other specified therapeutic percutaneous operations for twin to twin transfusion syndrome

Y33.8 Other specified puncture of organ NOC

Y95.- Gestational age

Y53.2 Approach to organ under ultrasonic control

Excludes: Laparoscopic ultrasonic approach to abdominal cavity (Y75.5)

Endoscopic ultrasonic approach to other body cavity (Y76.4)

Note:  A code from category Y95.- Gestational age must be assigned in a subsidiary position where this information is available.

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding}

Details

Contact details:

Links:

	IPG199 Septostomy with or without amnioreduction for the treatment of twin-to-twin transfusion syndrome: guidance (web format)	11 February 2011
	IPG199 Septostomy with or without amnioreduction for the treatment of twin-to-twin transfusion syndrome: guidance	13 December 2006
	IPG199 Septostomy for twin-to-twin transfusion syndrome (with or without amnioreduction): Understanding NICE guidance	06 December 2006
	IPG199 Septostomy for twin-to-twin transfusion syndrome (with or without amnioreduction): Understanding NICE guidance (MS Word format)	13 December 2006
	IPG199 Septostomi ar gyfer syndrom trallwysiad efaill i efaill (gyda neu heb amnioleihad): deall canllawiau NICE (fformat MS Word)	15 October 2009
	Septostomy with our without amnioreduction for the treatment of twin-to-twin transfusion syndrome: Audit Criteria	13 December 2007
	Amnioreduction using septostomy with or without amniodrainage for the treatment of twin-to-twin transfusion syndrome (interventional procedures consultation)	29 August 2006
	Amnioreduction using septostomy with or without amniodrainage for the treatment of twin-to-twin transfusion syndrome (interventional procedures overview)	29 August 2006