Outcome for children born after <i>in utero</i> laser ablation therapy for severe twin‐to‐twin transfusion syndrome

Sutcliffe, Alastair; Sebire, Neil J.; Pigott, Anna; Taylor, Brent; Edwards, Phil; Nicolaides, Kypros H.

doi:10.1111/j.1471-0528.2001.00294.x

Cited by 41 publications

(31 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sutcliffe et al (2001) found CP in 9% (6/66) of TTTS survivors treated with laser. Details on the number of children with severe cognitive delay were not reported.…”

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

confidence: 96%

“…The reported incidence of CP and NDI after laser surgery ranges from 3% to 12% and from 4% to 18%, respectively (Banek et al, 2003;Chang et al, 2012;De Lia et al, 1999;Graef et al, 2006;Graeve et al, 2012;Gray et al, 2011;Lenclen et al, 2009;Lopriore et al, 2009;McIntosh et al, 2014;Salomon et al, 2010;Sutcliffe et al, 2001;Vanderbilt et al, 2014). Table 2 summarizes the follow-up studies after laser surgery.…”

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

confidence: 99%

“…Up to now, no long-term outcome data of TTTS survivors following selective feticide of the co-twin are available. In a recent follow-up study, long-term NDI was detected in 7% (5/74) of co-twin survivors treated with selective reduction for severe complications, including TTTS, TAPS, twin-reversed arterial perfusion (TRAP), and selective fetal growth restriction (sFGR; van Klink, Koopman et al, 2015a). Of the 25 cases treated with selective reduction for TTTS, 2 (8%) were diagnosed with NDI.…”

Section: Other Interventions and Complications In Monochorionic Pregnmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2016

View full text Add to dashboard Cite

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.

show abstract

“…Sutcliffe et al (2001) found CP in 9% (6/66) of TTTS survivors treated with laser. Details on the number of children with severe cognitive delay were not reported.…”

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

confidence: 96%

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

confidence: 99%

Section: Other Interventions and Complications In Monochorionic Pregnmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Whereas there is some information on neonatal morbidity when amnioreduction was the principal therapy for TTTS, minimal data are available following laser therapy. Sutcliffe et al (2001) reported that 38% of surviving infants who delivered at a mean of 31 to 33 weeks' gestation were mechanically ventilated compared to the 20% in our cohort. Importantly, chronic lung disease which has been found to be associated with neurodevelopmental impairment occurred less frequently following introduction of the laser program.…”

Section: Discussionmentioning

confidence: 99%

Perinatal Outcomes With Laser Surgery for Twin–Twin Transfusion Syndrome

Gray¹,

Cincotta²,

Chan³

et al. 2006

Twin Res Hum Genet

View full text Add to dashboard Cite

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.

show abstract

“…Hay que considerar que el daño gemelos/ únicos es 7/1 (27) y no es claro el efecto de la coagulación (13% parálisis cerebral en sobrevivientes) (28).…”

Section: Discussionunclassified

Vía Del Nacimiento en Gemelar Monocoriónico Con Transfusión Intergemelar Y Terapia in Utero

2004

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

RESUMENEl propósito de la comunicación es revisar la vía del parto en embarazo gemelar complicado por Síndrome de Transfusión Gemelo-Gemelo (STGG) y por gemelo acardio con perfusión arterial reversa. La placentación del gemelar monocoriónico por sus anastomosis arteriales y venosas genera esas complicaciones que se asocian a una mortalidad cercana a 100% cuando no son tratadas en el período antenatal. Se describen dos casos de gemelar monocoriónico complicado, uno con STGG y otro, un acardio con perfusión reversa, ambos con diagnóstico ultrasónico precoz en primer trimestre y comienzo del segundo, que fueron exitosamente tratados in útero con coagulación láser sobre anastomosis vascular placentaria y sobre arteria umbilical pelviana obteniendo mejoría hemodinámica y recuperación de la funcionalidad placentaria. Se discuten aspectos generales del cuidado médico antenatal e intraparto del embarazo gemelar y específicamente del gemelar monocoriónico complicado. Se concluye que la terapia in útero fue exitosa además de mejorar el pronóstico puede favorecer la vía vaginal de parto.PALABRAS CLAVE: embarazo gemelar monocoriónico, anastomosis vasculares, terapia láser, parto vaginal SUMMARYThe aim of this communication is to review the way of delivering twin pregnancy complicated by either Twin to Twin Transfusion Syndrome (TTTS) or acardic twin with reverse arterial perfusion. The monochorionic placentae is characterised by superficial or deep vascular anastomosis which leads to the complications mentioned above, which are associated with almost 100% mortality when they are not treated antenatally. We describe two cases of severe TTTS and acardic twin with reverse arterial perfusion both diagnosed antenatally during the first and early second trimester of pregnancy on which laser treatment either on placental vascular anastomoses or pelvic single umbilical artery were done successfully. In addition of this we discuss some clinical aspects of prevention of premature delivery, antenatal and intrapartum medical care for twin pregnancy in general and specifically for complicated monochorionic twin pregnancy. We conclude that a successful fetal therapy improves pregnancy prognosis and makes possible vaginal delivery.

show abstract

Outcome for children born after in utero laser ablation therapy for severe twin‐to‐twin transfusion syndrome

Abstract: The overall cerebral palsy rate was 9%: 0% in the singleton survivors group and 13.3% in the twin survivors group. This pilot data highlights the need for careful long term follow up of children affected by twin-to-twin transfusion syndrome.

Cited by 41 publications

References 16 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

Perinatal Outcomes With Laser Surgery for Twin–Twin Transfusion Syndrome

Vía Del Nacimiento en Gemelar Monocoriónico Con Transfusión Intergemelar Y Terapia in Utero

Contact Info

Product

Resources

About