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 ,Revised 22 April 2009 ,Accepted 18 May 2009.

References 

  1. Lewi L, Jani J, Blickstein I, et al. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study. Am J Obstet Gynecol. 2008;199:514;e1-8
  2. van Gemert MJ, Umur A, Tijssen JG, Ross MG. Twin-twin transfusion syndrome: etiology, severity and rational management. Curr Opin Obstet Gynecol. 2001;13:193–206
  3. Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M. Staging of twin-twin transfusion syndrome. J Perinatol. 1999;19:550–555
  4. Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med. 2004;351:136–144
  5. Dickinson JE, Evans SF. The progression of disease stage in twin-twin transfusion syndrome. J Matern Fetal Neonatal Med. 2004;16:95–101
  6. Taylor MJ, Govender L, Jolly M, Wee L, Fisk NM. Validation of the Quintero staging system for twin-twin transfusion syndrome. Obstet Gynecol. 2002;100:1257–1265
  7. Duncombe GJ, Dickinson JE, Evans SF. Perinatal characteristics and outcomes of pregnancies complicated by twin-twin transfusion syndrome. Obstet Gynecol. 2003;101:1190–1196
  8. Huber A, Diehl W, Zikulnig L, Bregenzer T, Hackeloer BJ, Hecher K. Perinatal outcome in monochorionic twin pregnancies complicated by amniotic fluid discordance without severe twin-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2006;27:48–52
  9. O'Donoghue K, Cartwright E, Galea P, Fisk NM. Stage I twin-twin transfusion syndrome: rates of progression and regression in relation to outcome. Ultrasound Obstet Gynecol. 2007;30:958–964
  10. Roberts D, Gates S, Kilby M, Neilson JP. Interventions for twin-twin transfusion syndrome: a Cochrane review. Ultrasound Obstet Gynecol. 2008;31:701–711
  11. Wittman BK, Baldwin VJ, Nichol B. Antenatal diagnosis of twin transfusion syndrome by ultrasound. Obstet Gynecol. 1981;58:123–127
  12. Middeldorp JM, Sueters M, Lopriore E, et al. Fetoscopic laser surgery in 100 pregnancies with severe twin-to-twin transfusion syndrome in the Netherlands. Fetal Diagn Ther. 2007;22:190–194
  13. Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg. 1978;187:1–7
  14. An international classification of retinopathy of prematurity: prepared by an international committee. Br J Ophthalmol. 1984;68:690–697
  15. Lopriore E, Sueters M, Middeldorp JM, Oepkes D, Vandenbussche FP, Walther FJ. Neonatal outcome in twin-to-twin transfusion syndrome treated with fetoscopic laser occlusion of vascular anastomoses. J Pediatr. 2005;147:597–602
  16. Yamamoto M, El ML, Robyr R, Leleu F, Takahashi Y, Ville Y. Incidence and impact of perioperative complications in 175 fetoscopy-guided laser coagulations of chorionic plate anastomoses in fetofetal transfusion syndrome before 26 weeks of gestation. Am J Obstet Gynecol. 2005;193:1110–1116

 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

Article Tools

* Image Usage & Resolution