Endoscopic Laser Surgery versus Serial Amnioreduction for Severe Twin-to-Twin Transfusion Syndrome

Sénat, Marie-Victoire; Deprest, Jan; Boulvain, Michel; Paupe, A; Winer, Norbert; Ville, Y.

doi:10.1056/nejmoa032597

Cited by 1,233 publications

(1,147 citation statements)

References 33 publications

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“…In the majority of studies, cohorts included only a small number of children (range: 20-52 children). As a consequence, the investigators were unable to assess whether NDI was due to confounders such as prematurity or growth restriction (Senat et al, 2004). A clear definition of impairment, in terms of NDI, was often not reported, and detailed information on individual observations of impairment was often lacking.…”

Section: Long-term Neurodevelopmental Outcome In Ttts Treated With Ammentioning

confidence: 99%

Long-Term Neurodevelopmental Outcome in Survivors of Twin-to-Twin Transfusion Syndrome

et al. 2016

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Twin-twin transfusion syndrome (TTTS) is a severe complication of monochorionic (MC) twin pregnancies associated with high perinatal mortality and morbidity rates. Management in TTTS is a major challenge for obstetricians and neonatologists. Twins with TTTS are often born prematurely after an extremely distressing and highly hazardous fetal period. Follow-up studies report varying rates of cerebral palsy (CP) and longterm neurodevelopmental impairment (NDI). This review discusses the latest findings on the long-term outcome of TTTS survivors, possible risk factors for long-term impairment, and provides recommendations for future research.

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Section: Long-term Neurodevelopmental Outcome In Ttts Treated With Ammentioning

confidence: 99%

Long-Term Neurodevelopmental Outcome in Survivors of Twin-to-Twin Transfusion Syndrome

et al. 2016

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“…Fetoscopic laser therapy of the communicating vessels has been shown to be safe, effective and superior to serial amniodrainage in twin pregnancies 2 . Because of the rarity of monochorionic and dichorionic triplets 3 , at present little is known about the feasibility and success rate of laser therapy for TTTS in triplets.…”

Section: Introductionmentioning

confidence: 99%

Laser therapy of twin‐to‐twin transfusion syndrome in triplet pregnancies

Diemert

Diehl

Huber

et al. 2009

Ultrasound in Obstet & Gyne

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“…Diagnosis of TTTS was based on the Eurofetus criteria (Senat et al, 2004). TAPS was defined as the diagnostic criteria proposed by Slaghekke et al (2010).…”

Section: Methodsmentioning

confidence: 99%

Comparison Between Monochorionic and Dichorionic Placentas With Special Attention to Vascular Anastomoses and Placental Share

et al. 2016

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Placental vascular anastomoses in twins lead to a shared circulation and may subsequently enable the development of severe complications such as twin-twin transfusion syndrome (TTTS) and twin anemiapolycythemia sequence (TAPS). The presence of vascular anastomoses has frequently and systematically been studied in monochorionic (MC) placentas, but only rarely in dichorionic (DC) placentas. The aim of this study was to compare the prevalence of vascular anastomoses and evaluate the sharing discordance in MC and DC placentas. All consecutive placentas of MC and DC twins delivered at the Leiden University Medical Center (the Netherlands) and Medical University of Warsaw (Poland) from 2012 to 2015 were routinely injected with colored dye and included in the study. We excluded twin pregnancies treated with fetoscopic laser surgery. A total of 258 placentas were analyzed in this study, including 134 MC placentas and 124 DC placentas. Vascular anastomoses were present in 99% (133/134) of MC placentas and 0% of DC placentas (p < .01). Placental share discordance between MC twins was significantly larger compared to DC twins, 19.8 (interquartile range [IQR] 8.1-33.3) and 10.8 (IQR 6.2-19.0), respectively (p < .01). Vascular anastomoses associated complications occurred in 16% (22/134) MC twins. Our findings show that vascular anastomoses are almost ubiquitous in MC placentas, but non-existent in DC placentas. In addition, unequal placental sharing appears to be more common in MC than in DC placentas.

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Endoscopic Laser Surgery versus Serial Amnioreduction for Severe Twin-to-Twin Transfusion Syndrome

Abstract: Endoscopic laser coagulation of anastomoses is a more effective first-line treatment than serial amnioreduction for severe twin-to-twin transfusion syndrome diagnosed before 26 weeks of gestation.

Cited by 1,233 publications

References 33 publications

Long-Term Neurodevelopmental Outcome in Survivors of Twin-to-Twin Transfusion Syndrome

Long-Term Neurodevelopmental Outcome in Survivors of Twin-to-Twin Transfusion Syndrome

Laser therapy of twin‐to‐twin transfusion syndrome in triplet pregnancies

Comparison Between Monochorionic and Dichorionic Placentas With Special Attention to Vascular Anastomoses and Placental Share

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