Open AccessPlacental Abruption after Fetoscopic Laser Surgery in Twin-Twin Transfusion Syndrome: The Role of the Solomon Technique
Author(s) -
Patricia J.C. Knijnenburg,
Enrico Lopriore,
Yuchun Ge,
Irene M Scholl,
Jeanine M.M. van Klink,
Monique C. Haak,
Johanna M. Middeldorp,
Frans Klumper,
Dick Oepkes,
Luming Sun,
Femke Slaghekke
Publication year - 2021
Publication title -
fetal diagnosis and therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.976
H-Index - 60
eISSN - 1421-9964
pISSN - 1015-3837
DOI - 10.1159/000517800
Subject(s) - placental abruption , medicine , obstetrics , gestational age , retrospective cohort study , laser coagulation , population , surgery , pregnancy , gestation , genetics , environmental health , visual acuity , biology
Twin-twin transfusion syndrome (TTTS) is a complication in monochorionic twin pregnancies which is preferably treated with fetoscopic laser surgery. A few small studies suggested a possible association between the Solomon laser technique and placental abruption. Methods: The objective of this study is to compare the rate of and to explore potential risk factors for placental abruption in TTTS treated with fetoscopic laser surgery according to the Selective and Solomon laser technique. We conducted a large retrospective cohort study of consecutive TTTS-cases treated with fetoscopic laser surgery in Shanghai, China, and Leiden, The Netherlands treated with either the Selective laser technique (Selective group) or Solomon laser technique (Solomon group). Results: The rate of placental abruption in the Selective group versus the Solomon group was 1.7% (5/289) and 3.4% (15/441), respectively ( p = 0.184). No risk factors for placental abruption were identified. Placental abruption was associated with lower gestational age at birth ( p = 0.003) and severe cerebral injury ( p = 0.003). Conclusion: The prevalence of placental abruption in TTTS after fetoscopic laser surgery is low, although it appears higher than in the overall population. Placental abruption is associated with a lower gestational age at birth, which is associated with severe cerebral injury. The rate of placental abruption was not significantly increased with the use of the Solomon technique. Continued research of placental abruption in TTTS is necessary to determine why the rate is higher than in the overall population.