Twin-twin transfusion syndrome (TTTS) is a serious complication in monochorionic (MC) pregnancies. Fetoscopic laser surgery (FLS) is the primary treatment for advanced TTTS, but managing Quintero stage I TTTS is still controversial. We conducted an observational study evaluating the 2-year neurodevelopment of fetuses, which underwent FLS for stage I TTTS, compared with advanced TTTS and uncomplicated monochorionic diamniotic twins (MCDTs). The study included 156 children: 14 in stage I TTTS group, 28 in advanced TTTS group, and 114 in uncomplicated twin group. In stage I TTTS, 92.9% showed normal neurodevelopment, with no severe neurological impairments observed. These results were comparable with uncomplicated twins (92.1% normal neurodevelopment, = .921, adjusted odds ratio [aOR] = 1.56, 95% confidence interval [CI] = 0.42-5.79; 1.8% severe impairment, = .617). Advanced TTTS had a non-significant lower rate of normal neurodevelopment (89.3%, = .710, aOR = 1.31, 95% CI = 0.12-14.87). In conclusion, FLS for stage I TTTS shows favorable long-term neurodevelopmental outcomes, similar to uncomplicated MC pregnancies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/00099228241227087 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Resolution of selective fetal growth restriction after laser surgery for twin-to-twin transfusion syndrome can be predicted by predisease growth discordance.
Ultrasound Obstet Gynecol
January 2025
Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Objective: To determine if the resolution of fetal growth discordance after laser surgery in pregnancies with twin-to-twin transfusion syndrome (TTTS) and coexisting selective fetal growth restriction (sFGR) can be predicted by estimated fetal weight (EFW) discordance recorded prior to the development of TTTS (pre-TTTS).
Methods: This was a single-center, retrospective analysis of prospectively collected data on monochorionic twins with concurrent TTTS and sFGR that underwent laser surgery and had available growth ultrasound records from a pre-TTTS ultrasound evaluation. Maternal demographics, pregnancy characteristics and birth outcomes were compared between three outcome groups: double twin survival with resolved sFGR determined by birth weight discordance (BWD) < 20%; double twin survival with ongoing sFGR determined by BWD ≥ 20%; and single or double fetal demise after laser surgery.
Selective Extrauterine Placental Perfusion in Monochorionic Twins Is Feasible-A Case Series.
Children (Basel)
October 2024
Division of Neonatology, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Article Synopsis
- Monochorionic (MC) twins face risks like twin-to-twin transfusion syndrome (TTTS) and anemia, leading to potential complications during preterm delivery.
- A study investigated a new method called selective extrauterine placental perfusion (EPP) with delayed umbilical cord clamping (DCC) for the donor twin, aiming to reduce anemia while still managing the recipient's condition.
- The results showed that using this EPP method in three cases successfully maintained healthy hemoglobin levels in the donor twins without needing blood transfusions, suggesting it could improve outcomes in similar situations.
Predictive Indicators and Outcomes of Pregnancies Affected by Stage I Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation.
Prenat Diagn
November 2024
Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan.
Article Synopsis
- * Out of 272 twin pairs, the survival rates were very high, with 98% of at least one twin surviving and 85% for both, while 93% of recipient twins and 90% of donor twins survived.
- * The research identifies preoperative anemia-polycythemia sequence and arterio-arterial vascular anastomosis (AAA) as significant risk factors for mortality in donor twins after FLP, although the exact mechanisms of AAA need further investigation.
Survival rates in pregnancies complicated by twin-to-twin transfusion syndrome undergoing laser therapy: a systematic review and meta-analysis: Survival rates in twin-to-twin transfusion syndrome.
Am J Obstet Gynecol MFM
October 2024
Fetal Medicine Unit, Saint George's Hospital, London, UK; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; Twins and Multiples Centre for Research and Clinical Excellence; Fetal Medicine Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK. Electronic address:
Article Synopsis
- Twin-to-twin transfusion syndrome (TTTS) can cause problems for both babies, and doctors want to understand how severe it is to help with survival rates after treatment.
- They reviewed a lot of studies to see how well both twins survive depending on the severity of TTTS, which is measured in stages.
- The results showed that around 73% of twins survive when TTTS is stage I, but the survival drops to about 48% and 53% for stages III and IV, which are more severe.
Use of Web-Based Surveys to Collect Long-Term Pediatric Outcomes in Patients With Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation: Observational Study.
JMIR Pediatr Parent
September 2024
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston, 6410 Fannin Street, Suite 201, Houston, TX, 77030, United States, 1 (832) 325 7288, 1 713 383 1464.
Article Synopsis
- The study focused on assessing long-term pediatric outcomes for children with monochorionic diamniotic twins who underwent fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS).
- Researchers utilized a web-based survey through REDCap to collect parent-reported outcomes from families across the U.S. and beyond, targeting patients treated from 2011 to 2019.
- The study achieved a survey response rate of 37.3% in 2019 and 57.8% in 2020, with high completion rates across various questionnaires designed to evaluate the children's developmental status.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!