Objectives: Our aim was to evaluate the initial results of selective fetoscopic laser coagulation of placental equator for twin – to twin transfusion syndrome (TTTS). Methods: This was a prospective cohort study performed in a tertiary referral centre. The sonoendoscopic approach was used to identify the placental vascular equator and to photocoagulate crossing vessels. Results: Between April 2008 and March 2010, a total of 35 monochorionic diamniotic pregnancies, complicated by severe twin–twin transfusion syndrome before 26 weeks of gestation, underwent fetoscopic laser coagulation of placental blood vessels by 3 operators. Median gestational age was 20+1 weeks (interquartile range (IQR) 18+1–22+6 weeks) at fetoscopy and 34+4 weeks (IQR 32+4–36+0 weeks) at birth. There was at least one survivor in 66% (23/35) of pregnancies, and the overall survival rate was 54% (38/70). On average, seven vessels were ablated during each of the procedures, with a median operative time of 40 minutes (IQR 30–50 minutes). Recurrence of TTTS complicated 11% (4/35) of cases. Intraamniotic bleeding occurred in 2/35 patients. One of these cases was further complicated by maternal hemoperitoneum requiring blood transfusion and surgery. Conclusions: Our results of fetoscopic laser treatment for twin–twin transfusion syndrome are comparable to those reported in the literature
P06.09: Fetoscopic laser treatment for twin-twin transfusion syndrome: preliminary results from a new Italian center
FICHERA, Anna;F. Prefumo;
2010-01-01
Abstract
Objectives: Our aim was to evaluate the initial results of selective fetoscopic laser coagulation of placental equator for twin – to twin transfusion syndrome (TTTS). Methods: This was a prospective cohort study performed in a tertiary referral centre. The sonoendoscopic approach was used to identify the placental vascular equator and to photocoagulate crossing vessels. Results: Between April 2008 and March 2010, a total of 35 monochorionic diamniotic pregnancies, complicated by severe twin–twin transfusion syndrome before 26 weeks of gestation, underwent fetoscopic laser coagulation of placental blood vessels by 3 operators. Median gestational age was 20+1 weeks (interquartile range (IQR) 18+1–22+6 weeks) at fetoscopy and 34+4 weeks (IQR 32+4–36+0 weeks) at birth. There was at least one survivor in 66% (23/35) of pregnancies, and the overall survival rate was 54% (38/70). On average, seven vessels were ablated during each of the procedures, with a median operative time of 40 minutes (IQR 30–50 minutes). Recurrence of TTTS complicated 11% (4/35) of cases. Intraamniotic bleeding occurred in 2/35 patients. One of these cases was further complicated by maternal hemoperitoneum requiring blood transfusion and surgery. Conclusions: Our results of fetoscopic laser treatment for twin–twin transfusion syndrome are comparable to those reported in the literatureI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
