How is amnio used for twin-twin transfusion?

Amnioreduction.: Before laser therapy became trendy for ttts management, serial amnioreductions with or without amnioseptostomy were successfully used to increase perinatal survival in such complicated twin pregnancies. The decrease of amniotic fluid volume in the recipient's sac alleviates the pressure on the placenta and helps prolong the pregnancy while avoiding fetal demise; neurological damage can still occur.