| Management of Stage I twin-to-twin transfusion syndrome: an international survey. | |
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MedLine Citation:
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PMID: 20104530 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine practice patterns for evaluation and treatment of Stage I twin-to-twin transfusion syndrome (TTTS) among international physicians. METHODS: An e-mail cross-sectional survey of members from the IFMSS, NAFTNet and SMFM societies and participants at a Eurofoetus-sponsored TTTS meeting was undertaken between May 2008 and November 2008. Questionnaires consisted of physician demographics and their recommendations for managing Stage I TTTS. Alternative therapies to expectant management were assessed based on the following special circumstances of the patient: residence more than 200 miles from the center, severe symptoms, or a cervical length of </= 15 mm. RESULTS: Eighty-one surveys were returned, giving a response rate of 84%. Five surveys were excluded as a result of duplication or missing data. Of the remaining 76 surveys, 48 were from North America, 20 were from Europe and eight were from other continents. Expectant management was the predominant recommendation (78%), followed by amnioreduction (11%), laser ablation (11%) and septostomy (1%). Recommendations for amnioreduction were exclusively from North American centers. Laser centers recommended expectant management more frequently than non-laser facilities (89% vs. 59%; P < 0.01). When examples of special patient circumstances were presented, North American centers changed their recommendation from expectant management to amnioreduction more often than did European centers. However, a greater proportion of European centers recommended laser surgery for special patient circumstances. CONCLUSION: Expectant management remains the predominant management of Stage I TTTS. In some patient circumstances, North American centers are more likely to recommend amnioreduction while European centers are more likely to recommend laser therapy. A randomized controlled trial will be necessary to evaluate the most efficacious management strategy for Stage I TTTS. |
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Authors:
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S Molina; R Papanna; K J Moise; A Johnson |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 36 ISSN: 1469-0705 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-01 Completed Date: 2010-12-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
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Languages: eng Pagination: 42-7 Citation Subset: IM |
Copyright Information:
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Copyright 2010 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and The Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX 77030, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cross-Sectional Studies Electronic Mail Europe Female Fetofetal Transfusion / diagnosis, therapy* Fetoscopy / statistics & numerical data* Health Care Surveys Humans Laser Coagulation / statistics & numerical data* Male North America Physician's Practice Patterns / statistics & numerical data* Pregnancy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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