[Outcome of triplet pregnancies managed for twin-to-twin transfusion syndrome: A single center experience].

J Gynecol Obstet Biol Reprod (Paris)

Centre maladies rares, syndrome transfuseur-transfusé, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Maternité et service de médecine fœtale, hôpital Necker-Enfants-Malades, université Paris Descartes, Sorbonne Paris Cité, AP-HP, 149, rue de Sèvres, Paris, France. Electronic address:

Published: October 2016

Objectives: Study the outcomes of triplet pregnancies (GGG) complicated with twin-to-twin transfusion syndrome (TTTS) treated with laser fetoscopy.

Methods: Retrospective study of interventions, outcomes and perinatal follow-up of GGG treated for TTS.

Results: Between 2002 and 2013, 25 GGG complicated by TTTS were seen in our center, 20 dichorionic and 5 monochorionic. The mean gestational age (GA) at diagnosis of TTTS was 19.7 GW (±2.4) with 2, 4, 16 and 1 pregnancies at Quintero's stage I, II, III and V, respectively. They had a fetoscopy at an average GA of 19 GW and 6 days. There were 3 (13.0%) late miscarriages. The average GA at delivery was of 29.6 GW overall (26.3 GW and 31.1 GW in monochorionic and dichorionic pregnancies respectively). The overall fetal survival rate was 57.97% (40% and 66.7% in the group of monochorionic dichorionic pregnancies, respectively). However, neonatal mortality (<28 days) is 17.5%.

Conclusion: GGG operated by fetoscopy for TTTS have a survival rate of three, at least 2 and at least 1 fetus of 21.7%, 69.6% and 82.6% respectively. The overall fetal survival rate is 59.97%. There is a tendency for better survival rates in dichorionic GGG compared to monochorionic GGG (P=0.079).

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http://dx.doi.org/10.1016/j.jgyn.2015.08.006DOI Listing

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