TY - JOUR
T1 - Stage-based outcomes of 682 consecutive cases of twintwin transfusion syndrome treated with laser surgery
T2 - The USFetus experience
AU - Chmait, Ramen H.
AU - Kontopoulos, Eftichia V.
AU - Korst, Lisa M.
AU - Llanes, Arlyn
AU - Petisco, Ileana
AU - Quintero, Rubn A.
PY - 2011/5
Y1 - 2011/5
N2 - Objective: We sought to describe stage-specific perinatal outcomes after selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome. Study design: Patients with twin-twin transfusion syndrome underwent SLPCV preferentially using sequential vs standard laser technique. Patient characteristics and outcome data were examined by Quintero stage. Results: Of 682 consecutive women studied, the Quintero stage distribution was: 114 stage I (17%), 177 stage II (26%), 328 stage III (48%), and 63 stage IV (9%). Perinatal survival of at least 1 twin did not differ according to stage (I-92%, II-93%, III-88%, IV-92%; P = .30). However, dual twin survival differed by stage (I-79%, II-76%, III-59%, IV-68%; P < .01), primarily because stage III pregnancies were associated with decreased donor twin survival (P < .01). Sequential SLPCV was associated with improved donor survival, independent of stage (odds ratio, 1.67; 95% confidence interval, 1.162.40; P < .01). Conclusion: Stage-specific perinatal outcomes after laser therapy may assist physicians in patient counseling and in planning future studies.
AB - Objective: We sought to describe stage-specific perinatal outcomes after selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome. Study design: Patients with twin-twin transfusion syndrome underwent SLPCV preferentially using sequential vs standard laser technique. Patient characteristics and outcome data were examined by Quintero stage. Results: Of 682 consecutive women studied, the Quintero stage distribution was: 114 stage I (17%), 177 stage II (26%), 328 stage III (48%), and 63 stage IV (9%). Perinatal survival of at least 1 twin did not differ according to stage (I-92%, II-93%, III-88%, IV-92%; P = .30). However, dual twin survival differed by stage (I-79%, II-76%, III-59%, IV-68%; P < .01), primarily because stage III pregnancies were associated with decreased donor twin survival (P < .01). Sequential SLPCV was associated with improved donor survival, independent of stage (odds ratio, 1.67; 95% confidence interval, 1.162.40; P < .01). Conclusion: Stage-specific perinatal outcomes after laser therapy may assist physicians in patient counseling and in planning future studies.
KW - Quintero stage
KW - sequential laser surgery
KW - twin-twin transfusion syndrome
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U2 - 10.1016/j.ajog.2011.02.001
DO - 10.1016/j.ajog.2011.02.001
M3 - Article
C2 - 21411051
AN - SCOPUS:79955615947
VL - 204
SP - 393.e1-393.e6
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 5
ER -