This paper reports the experience with acute polyhydramnios complicating twin pregnancies at the Mercy Maternity Hospital for the 10-year and 2-month period from January, 1979 to February, 1989 during which time there were 13 such cases, an incidence of 1 in 4,044 pregnancies. Acute polyhydramnios complicated 1.7% of all twin pregnancies. The perinatal mortality rate was 88.5% and accounted for 16.7% of the perinatal deaths in twins. No major fetal malformations were found. One case of acute polyhydramnios was successfully managed with ultrasonographically guided serial amniocenteses. The management of this rare condition is considered.

Objective To assess the efficacy of transcervical resection of the endometrium (TCRE) in women presenting with menstrual disorders. Design A retrospective audit of 400 patients. Setting The Department of Gynaecology, St John's Hospital, Chelmsford, Essex. Subjects 400 consecutive referrals with various bleeding disorders which were suitable for treatment with TCRE. Interventions TCRE, either partially or completely. Main outcome measures Patient satisfaction with procedure at 4 months. The procedure was initially recorded as a failure if any further therapy was required but satisfaction after a second procedure was assessed. Results 432 procedures were performed in 400 women. Major operative complications were rare with two (0.46%) uterine perforations, four (0.93%) primary haemorrhages requiring Tamponade to control bleeding and one (0.23%) secondary haemorrhage requiring hysterectomy to control it. Glycine toxicity was not clinically apparent. 85% were satisfied after the initial TCRE and 92% were satisfied if the procedure was repeated. Conclusion TCRE is an advance in the management of menstrual disorders. Extensive training is required to minimise complications. The lack of long term follow‐up is its major deficiency but this will be rectified in the future.

Objective To assess the efficacy of transcervical resection of the endometrium (TCRE) in women presenting with menstrual disorders. Design A retrospective audit of 400 patients. Setting The Department of Gynaecology, St John's Hospital, Chelmsford, Essex. Subjects 400 consecutive referrals with various bleeding disorders which were suitable for treatment with TCRE. Interventions TCRE, either partially or completely. Main outcome measures Patient satisfaction with procedure at 4 months. The procedure was initially recorded as a failure if any further therapy was required but satisfaction after a second procedure was assessed. Results 432 procedures were performed in 400 women. Major operative complications were rare with two (0.46%) uterine perforations, four (0.93%) primary haemorrhages requiring Tamponade to control bleeding and one (0.23%) secondary haemorrhage requiring hysterectomy to control it. Glycine toxicity was not clinically apparent. 85% were satisfied after the initial TCRE and 92% were satisfied if the procedure was repeated. Conclusion TCRE is an advance in the management of menstrual disorders. Extensive training is required to minimise complications. The lack of long term follow‐up is its major deficiency but this will be rectified in the future.