Triplets with feto-fetal transfusion syndrome treated with laser ablation: The USFetus experience

Ramen H. Chmait, Eftichia Kontopoulos, Patricia W. Bornick, Terri Maitino, Rubén A. Quintero

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

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 dichorionictriamniotic (D/T) or monochorionictriamniotic (M/T). In M/T triplets, SLPCV between FFTS affected recipientdonor 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.

Original languageEnglish
Pages (from-to)361-365
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume23
Issue number5
DOIs
StatePublished - May 1 2010

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Keywords

  • Dichorionic triplets
  • Feto-fetal transfusion syndrome
  • Laser ablation
  • Monochorionic triplets
  • Twintwin transfusion syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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