American Journal of Obstetrics & Gynecology
Volume 201, Issue 3 , Pages 286.e1-286.e6, September 2009

Short- and long-term outcome in stage 1 twin-to-twin transfusion syndrome treated with laser surgery compared with conservative management

Presented at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 26-31, 2009.

  • Marise M. Wagner, MD

      Affiliations

    • Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Enrico Lopriore, MD, PhD

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Frans J. Klumper, MD

      Affiliations

    • Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Dick Oepkes, MD, PhD

      Affiliations

    • Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Frank P.H.A. Vandenbussche, MD, PhD

      Affiliations

    • Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
    • ,
  • Johanna M. Middeldorp, MD, PhD

      Affiliations

    • Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
    • Corresponding Author InformationReprints: Johanna M. Middeldorp, MD, PhD, Department of Obstetrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands

Received 5 February 2009; received in revised form 22 April 2009; accepted 18 May 2009. published online 23 July 2009.

Objective

We sought to compare short- and long-term outcome in Quintero stage 1 twin-to-twin transfusion syndrome (TTTS), managed with laser surgery or conservatively.

Study Design

We conducted a retrospective study of all monochorionic twin pregnancies with stage 1 TTTS referred to our center. Primary outcomes were perinatal survival, neonatal morbidity, and long-term neurodevelopmental outcome.

Results

Fifty women presented with stage 1 TTTS of which 40% (20/50) was treated with laser and 60% (30/50) was managed conservatively. Perinatal survival of both or at least 1 twin was 65% (13/20) and 85% (17/20) in the laser group, and 77% (23/30) and 97% (29/30) in the conservatively managed group (P = .52 and P = .29), respectively. Long-term neurodevelopmental impairment of the surviving infants was found in 0% (0/21) vs 23% (7/30), respectively (P = .03).

Conclusion

In this retrospective study, long-term outcome in stage 1 TTTS was better after laser surgery than with conservative management, suggesting the need for a randomized controlled trial.

Key words: long-term outcome, perinatal outcome, Quintero stage 1, twin-to-twin transfusion syndrome

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 Cite this article as: Wagner MM, Lopriore E, Klumper FJ, et al. Short- and long-term outcome in stage 1 twin-to-twin transfusion syndrome treated with laser surgery compared with conservative management. Am J Obstet Gynecol 2009;201:286.e1-6.

PII: S0002-9378(09)00542-0

doi:10.1016/j.ajog.2009.05.034

American Journal of Obstetrics & Gynecology
Volume 201, Issue 3 , Pages 286.e1-286.e6, September 2009

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