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Laser therapy of twin‐to‐twin transfusion syndrome in triplet pregnancies
Author(s) -
Diemert A.,
Diehl W.,
Huber A.,
Glosemeyer P.,
Hecher K.
Publication year - 2010
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.7328
Subject(s) - medicine , fetoscopy , laser coagulation , twin to twin transfusion syndrome , gestational age , twin twin transfusion syndrome , obstetrics , anastomosis , laser surgery , fetus , laser therapy , survival rate , pregnancy , twin pregnancy , monochorionic twins , surgery , prenatal diagnosis , laser , genetics , physics , visual acuity , optics , biology
Objective Laser coagulation of placental anastomoses in twin pregnancies complicated by severe twin‐to‐twin transfusion syndrome (TTTS) has been shown to be superior to serial amniodrainage, and has emerged as the standard therapy for this condition. We report the outcome of triplet pregnancies treated with laser therapy for severe TTTS. Methods From a database containing information on all multiple pregnancies referred to our center we identified 20 triplet pregnancies with severe TTTS. Sixteen of them were dichorionic, four monochorionic and all cases were triamniotic. Perinatal outcome was obtained in all cases. Results Fetoscopy was performed in 18 out of 20 cases at a median gestational age of 19.7 (range, 17.0–23.3) weeks. Delivery occurred at a median of 31.9 (range, 24.7–36.4) weeks with an overall fetal survival rate of 65%, at least one surviving fetus in 83% of cases and all three fetuses surviving in 39%. Conclusion Laser coagulation is an effective treatment for severe TTTS in triplets. However, survival rates are lower than in twin pregnancies. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.