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Perinatal outcomes of single fetal survivor after fetal intervention for complicated monochorionic twins
Author(s) -
Hoffman Mallory,
Habli Mounira,
Donepudi Roopali,
Boring Noemi,
Johnson Anthony,
Moise Kenneth J.,
Papanna Ramesha
Publication year - 2018
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5278
Subject(s) - medicine , monochorionic twins , fetoscopy , obstetrics , gestational age , fetus , twin to twin transfusion syndrome , rupture of membranes , pregnancy , prenatal diagnosis , genetics , biology
Objective To compare perinatal outcomes between acute single fetal demise following fetoscopic laser photocoagulation to planned selective reduction (SR) in complicated monochorionic twin pregnancies. Methods This was a secondary analysis of prospectively collected data in complicated monochorionic twin pregnancies from 2 fetal centers from 2011 to 2016. Group 1 included women undergoing fetoscopic laser photocoagulation for twin‐twin transfusion syndrome (TTTS) who experienced a single fetal demise within 24 hours of the procedure. Group 2 consisted of women undergoing planned selective reduction (SR) with TTTS, and Group 3 SR for indications other than TTTS. Results Survival of the remaining co‐twin at birth was highest in Group 1 (n = 77 patients; 95%) compared with that in Group 2 ( n = 15; 80%) and Group 3 ( n = 32; 78%; P = .047). The preterm premature rupture of membrane rate was higher in Group 1 (47%) compared with that in Group 2 (33%) and Group 3 (7%; P < .001). Group 1 had a lower gestational age at delivery and shorter procedure‐to‐delivery interval compared with the other 2 groups ( P < .01). Conclusion When single fetal demise occurs following fetoscopic laser photocoagulation, the surviving co‐twin is more likely to survive to delivery but has higher PPROM rates and a shorter latency period compared with planned selective reduction for TTTS or other indications.