Document Detail


Triplets with feto-fetal transfusion syndrome treated with laser ablation: the USFetus experience.
MedLine Citation:
PMID:  19658042     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We sought to assess outcomes of triplets with feto-fetal transfusion syndrome (FFTS) treated with selective laser photocoagulation of communicating vessels (SLPCV). STUDY DESIGN: All twins and triplets with FFTS treated with SLPCV were analyzed. Triplets were classified as dichorionic-triamniotic (D/T) or monochorionic-triamniotic (M/T). In M/T triplets, SLPCV between FFTS affected recipient-donor pairs was performed first (step 1); SLPCV of remaining vascular communications was then attempted (step 2). RESULTS: Forty-six of 692 (6.7%) gestations with FFTS treated with SLPCV were triplets; 40 (87%) were D/T, 6 (13%) were M/T. Overall perinatal survivorship in triplets versus twins were not different (73.9% vs. 75.1%, p = 0.757). SLPCV was achieved in 93% of D/T triplets. In the M/T triplets, step 1 was successful in all cases, and step 2 in half of cases. The D/T group delivered later in gestation than the M/T group (31.6 vs. 27.0 weeks, p = 0.049); no difference in overall perinatal survival was detected (75.8% vs. 61.1%, p = 0.248). CONCLUSION: Overall perinatal survival of triplets and twins with FFTS treated via SLPCV is similar. Significant surgical challenges were posed by monochorionic versus dichorionic triplets. Further studies of monochorionic triplets are required to ascertain perinatal survival post-SLPCV in this subset of triplets.
Authors:
Ramen H Chmait; Eftichia Kontopoulos; Patricia W Bornick; Terri Maitino; Rubén A Quintero
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2010-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  361-5     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University Southern California, Los Angeles, California 90027, USA. chmait@usc.edu
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Therapies / methods,  statistics & numerical data
Fetofetal Transfusion / surgery*
Humans
Laser Therapy / methods*
Pregnancy
Pregnancy, Multiple
Retrospective Studies
Syndrome
Treatment Outcome
Triplets*
Twins
United States

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


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