Subsequent fertility, pregnancy, and gynecologic outcomes after fetoscopic laser therapy for twin-twin transfusion syndrome compared with normal monochorionic twin gestations

Vergote, Simen; Lewi, Liesbeth; Gheysen, Willem; Catte, Luc De; Devlieger, Roland; Deprest, Jan

doi:10.1016/j.ajog.2018.01.013

Cited by 13 publications

(18 citation statements)

References 15 publications

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“…Three out of 24 mothers who opted for MFS were diagnosed with mental health issues after birth of their baby, which they relate to events they experienced during their pregnancy trajectory. Earlier studies have reported depression and anxiety in patients undergoing fetal diagnosis or receiving fetal therapy, suggesting that women underdoing MFS require appropriate follow‐up and support to detect increased risks of mood and anxiety disorders 37‐39 . This was already the case in women with fetal SB in the pre‐fetal surgery era, 40,41 to which the stress of the MFS and potential complications of prematurity is now added.…”

Section: Discussionmentioning

confidence: 99%

‘We did everything we could’– a qualitative study exploring the acceptability of maternal‐fetal surgery for spina bifida to parents

Crombag

Sacco

Stocks³

et al. 2021

Prenatal Diagnosis

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Objective: To explore the concepts and strategies parents employ when considering maternal-fetal surgery (MFS) as an option for the management of spina bifida (SB) in their fetus, and how this determines the acceptability of the intervention. Methods:A two-centre interview study enrolling parents whose fetuses with SB were eligible for MFS. To assess differences in acceptability, parents opting for MFS (n = 24) were interviewed at three different moments in time: prior to the intervention, directly after the intervention and 3-6 months after birth. Parents opting for termination of pregnancy (n = 5) were interviewed only once. Themes were identified and organised in line with the framework of acceptability. Results:To parents opting for MFS, the intervention was perceived as an opportunity that needed to be taken. Feelings of parental responsibility drove them to do anything in their power to improve their future child's situation. Expectations seemed to be realistic yet were driven by hope for the best outcome. None expressed decisional regret at any stage, despite substantial impact and, at times, disappointing outcomes. For the small group of participants, who decided to opt for termination of pregnancy (TOP), MFS was not perceived as an intervention that substantially could improve the quality of their future child's life. Conclusion:Prospective parents opting for MFS were driven by their feelings of parental responsibility. They recognise the fetus as their future child and value information and care focusing on optimising the child's future health. In the small group of parents opting for TOP, MFS was felt to offer insufficient certainty of substantial improvement in quality of life and the perceived severe impact of SB drove their decision to end the pregnancy. Key pointsWhat's already known about this topic? � Maternal-fetal surgery for open spina bifida has the potential to improve long-term outcomes but at significant procedure-related fetal and maternal risk; 910 -Prenatal Diagnosis.

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Section: Discussionmentioning

confidence: 99%

‘We did everything we could’– a qualitative study exploring the acceptability of maternal‐fetal surgery for spina bifida to parents

Crombag

Sacco

Stocks³

et al. 2021

Prenatal Diagnosis

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“…Monochorionic diamniotic (MCDA) twins comprise 20-30% of spontaneous and 4-5% of iatrogenic twin gestations. MCDA pregnancies are at higher risk for perinatal complications than dichorionic twins and singleton pregnancies [23]. This is attributed to the presence of vascular anastomoses connecting the fetal circulations.…”

Section: Discussionmentioning

confidence: 99%

Identification of Crucial Methylation Genes Associated With Immune Cell Infiltration in Twin-to-twin Transfusion Syndrome Using Co-methylation Analysis

Wang

Liu

et al. 2021

Preprint

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Background: DNA methylation (DNAm), is an important transcriptional regulation mechanism, relevant to various diseases. Twin-to-twin transfusion syndrome (TTTS) is a complication in twin pregnancies resulting from disproportionate blood circulation. Survivors of TTTS show a high risk of neurodevelopmental abnormalities, particularly in the hippocampus, which is important in learning and memory. Here, we investigate gene expression and DNAm in hippocampus tissues of TTTS specimens. Methods: DNAm and gene expression levels were compared among the three groups: 10 recipients, 10 donors, and 10 matched control, using methylation microarray. We further explored the immune infiltration of six immune cell sub-populations using EpiDISH analysis. The methylated sites related to immune cell infiltration were identified using the WGCNA package. We explored the core methylation genes in the protein-protein interaction network using the MCODE plugin in Cytoscape software. Results: There were 188 differential methylation sites among three groups. Based on WGCNA, we found that the turquoise module containing 174 CpG sites is significantly related to the immune infiltration level. And four hub genes correlated with immune infiltration level, namely, PTPRJ, FYN, LYN, and AKT1, and were identified using gene sub-network analysis. Conclusions: We identify the four hub methylation genes related to immune infiltration in the TTTS. The molecular function of hub genes is still explored in the future research.

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“…Previous studies have indicated that women with TTTS pregnancies may experience anxiety, depression, posttraumatic stress, and higher parenting pressure, thereby necessitating urgent clinical attention for their mental state. [6][7][8][9] However, based on current research, the lived experiences and actual thoughts during pregnancy and postpartum cannot be de nitively determined, which precludes adequate the provision of targeted treatments. In this regard, qualitative research is a method used to describe the life experiences of research subjects, capturing their emotions, beliefs, and behaviours.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy and Parenting Experiences of Women With Twin-to-twin Transfusion Syndrome: A Qualitative Study

Ren

Song

Xia

et al. 2020

Preprint

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BackgroundQualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support.MethodsA semi-structured interview method was used to assess the pregnancy and parenting experiences of women who presented with TTTS.ResultsWomen who presented with TTTS during pregnancy experienced persistent worry about their children’s health from the disease diagnosis to the subsequent parenting processes, when slight changes in their children’s health elicited concern. The lack of an efficient referral process and health information increased their uncertainty about their children’s health.ConclusionIn addition to the children’s health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Regardless of whether with successful delivery, women who experiencing TTTS may be more susceptible to psychological problems. Clinicians should improve the referral process and establish a follow-up system to provide women with health information and psychological support.

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Subsequent fertility, pregnancy, and gynecologic outcomes after fetoscopic laser therapy for twin-twin transfusion syndrome compared with normal monochorionic twin gestations

Cited by 13 publications

References 15 publications

‘We did everything we could’– a qualitative study exploring the acceptability of maternal‐fetal surgery for spina bifida to parents

‘We did everything we could’– a qualitative study exploring the acceptability of maternal‐fetal surgery for spina bifida to parents

Identification of Crucial Methylation Genes Associated With Immune Cell Infiltration in Twin-to-twin Transfusion Syndrome Using Co-methylation Analysis

Pregnancy and Parenting Experiences of Women With Twin-to-twin Transfusion Syndrome: A Qualitative Study

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