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Incidence and clinical implications of early inadvertent septostomy after laser therapy for twin-twin transfusion syndrome.
MedLine Citation:
PMID:  21225657     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the incidence and clinical outcome of inadvertent septostomy after fetoscopic laser therapy for twin-twin transfusion syndrome (TTTS). METHODS: In a cohort of 414 consecutive monochorionic twin pregnancies treated with laser, the incidence of post-operative septostomy within one week of the procedure was prospectively recorded, and the rate of preterm delivery, preterm premature rupture of membranes (PPROM), intrauterine fetal demise (IUFD), and pseudoamniotic band syndrome (PABS) were compared among cases with and without septostomy. RESULTS: Mean gestational age at therapy was 20.4 (15.3-27.6) weeks. Septostomy occurred in 30 cases (7.2%). Pregnancies complicated with septostomy had a significantly higher proportion of preterm delivery before 32 weeks (76.6% vs. 30.2%, P<0.001), PPROM (46.7% vs. 19.0%, p<0.001), IUFD (43.3% vs. 25.8%, p<0.05) and PABS (13.3% vs. 1.0%, p<0.001). CONCLUSION: Inadvertent septostomy occurred in 7% of cases after fetoscopic laser therapy and was associated with a substantially increased risk of adverse perinatal outcome and with an increased incidence of PABS. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Rogelio Cruz-Martinez; Tim Van Mieghem; Liesbeth Lewi; Elisenda Eixarch; Teresa Cobo; Josep M Martinez; Jan Deprest; Eduard Gratacos
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-10
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Maternal-Fetal Medicine, Institute Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
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