Document Detail


Perinatal outcomes with laser surgery for twin-twin transfusion syndrome.
MedLine Citation:
PMID:  16790154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this tertiary hospital-based cohort study was to determine and compare perinatal outcome and neonatal morbidities of pregnancies with twin-twin transfusion syndrome (TTTS) before and after the introduction of a treatment program with laser ablation of placental communicating vessels. Twenty-seven pregnancies with Stage II-IV TTTS treated with amnioreduction were identified (amnioreduction group). The data were compared with that obtained from the first 31 pregnancies with Stage II-IV TTTS managed with laser ablation of placental communicating vessels (laser group). Comparisons were made for perinatal survival and neonatal morbidities including abnormalities on brain imaging. The median gestation at therapy was similar between the two groups (20 vs. 21 weeks, p = .24), while the median gestation at delivery was significantly greater in the laser treated group (34 vs. 28 weeks, p = .002). The perinatal survival rate was higher in the laser group (77.4% vs. 59.3%, p = .03). Neonatal morbidities including acute respiratory distress, chronic lung disease, requirement for ventilatory assistance, patent ductus arteriosus, hypotension, and oliguric renal failure had a lower incidence in the laser group. On brain imaging, ischemic brain injury was seen in 12% of the amnioreduction group and none of the laser group of infants (p = .01). In conclusion, these findings indicate that perinatal outcomes are improved with less neonatal morbidity for monochorionic pregnancies with severe TTTS treated by laser ablation of communicating placental vessels when compared to treatment by amnioreduction.
Authors:
Peter H Gray; Robert Cincotta; Fung Yee Chan; Barbara Soong
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Publication Detail:
Type:  Comparative Study; Journal Article; Twin Study    
Journal Detail:
Title:  Twin research and human genetics : the official journal of the International Society for Twin Studies     Volume:  9     ISSN:  1832-4274     ISO Abbreviation:  -     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-22     Completed Date:  2006-08-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101244624     Medline TA:  Twin Res Hum Genet     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  438-43     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Mater Mothers' Hospital, University of Queensland, Brisbane, Australia. Peter.Gray@mater.org.au
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MeSH Terms
Descriptor/Qualifier:
Endoscopy
Female
Fetofetal Transfusion / mortality,  surgery*,  ultrasonography
Humans
Infant, Newborn
Laser Therapy / methods*
Placenta / blood supply
Pregnancy
Pregnancy Outcome*
Statistics, Nonparametric
Survival Analysis
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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