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P06.09: Fetoscopic laser treatment for twin–twin transfusion syndrome: preliminary results from a new Italian center
Author(s) -
Fratelli N.,
Fichera A.,
Prefumo F.,
Zanardini C.,
Marella D.,
Frusca T.
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.8384
Subject(s) - medicine , fetoscopy , twin to twin transfusion syndrome , laser coagulation , gestational age , obstetrics , surgery , interquartile range , blood transfusion , gestation , laser surgery , pregnancy , fetus , prenatal diagnosis , laser , genetics , biology , physics , visual acuity , optics
Objectives: Our aim was to evaluate the initial results of selectivefetoscopic laser coagulation of placental equator for twin – to twintransfusion syndrome (TTTS).Methods: This was a prospective cohort study performed in atertiary referral centre. The sonoendoscopic approach was usedto identify the placental vascular equator and to photocoagulatecrossing vessels.Results: Between April 2008 and March 2010, a total of 35monochorionic diamniotic pregnancies, complicated by severetwin–twin transfusion syndrome before 26 weeks of gestation,underwent fetoscopic laser coagulation of placental blood vessels by3 operators. Median gestational age was 20+1 weeks (interquartilerange (IQR) 18+1–22+6 weeks) at fetoscopy and 34+4 weeks (IQR32+4–36+0 weeks) at birth. There was at least one survivor in66% (23/35) of pregnancies, and the overall survival rate was 54%(38/70). On average, seven vessels were ablated during each ofthe procedures, with a median operative time of 40 minutes (IQR30–50 minutes). Recurrence of TTTS complicated 11% (4/35) ofcases. Intraamniotic bleeding occurred in 2/35 patients. One ofthese cases was further complicated by maternal hemoperitoneumrequiring blood transfusion and surgery.Conclusions: Our results of fetoscopic laser treatment for twin–twintransfusion syndrome are comparable to those reported in theliteratur