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Invasive treatment in complicated monochorionic twin pregnancies: Indications and outcome of 120 consecutively treated pregnancies.
MedLine Citation:
PMID:  22708557     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: Monochorionic twin pregnancies are associated with increased risk of severe complications. Umbilical cord occlusion (UCO) and fetoscopic selective laser coagulation (FSLC) are used as invasive treatment. The study aim was to document treatment indications and pregnancy outcome where UCO and FSLC were used for treating fetal discrepancies and twin to twin transfusion syndrome (TTTS). Design: Cohort study of all consecutively treated monochorionic twin pregnancies 2004-2010. Setting: Tertiary care centre. Population: 120 pregnancies treated by FSLC (55) or UCO (65). UCO was undertaken in 49 TTTS cases, 4 cases with fetal abnormality and TTTS and in 12 because of fetal anomaly only. Main Outcome Measures: Overall survival per fetus, survival per pregnancy of at least one fetus and further according to the Quintero stages. Infant survival, until, at least one week after birth. Results: 84% had TTTS, 13% had a fetal malformation and 3% had both. Of TTTS cases 69% were Quintero stage 3 and 4. In the UCO group with TTTS 87% were in stage 3 and 4. Survival in the UCO group was 82%, and in the laser group the survival of at least one fetus was 85%, overall survival per fetus was 60%. Conclusions: TTTS in Quintero stage 3 was by far the most common indication. Outcome by means of survival after FSLC and UCO were similar to what has been reported elsewhere. Cord occlusion was accepted treatment alternative to fetoscopic selective laser coagulation in severe TTTS cases.
Authors:
Karin Sundberg; Kirsten Søgaard; Lisa Neerup Jensen; Katrine Vasehus Schou; Connie Jørgensen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-18
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors AOGS© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Fetal Medicine and Ultrasound, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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