Laser coagulation of placental anastomoses with a 30° fetoscope in severe mid-trimester twin–twin transfusion syndrome with anterior placenta
Article first published online: 10 MAR 2008
Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 31, Issue 4, pages 412–416, April 2008
How to Cite
Huber, A., Baschat, A. A., Bregenzer, T., Diemert, A., Tchirikov, M., Hackelöer, B. J. and Hecher, K. (2008), Laser coagulation of placental anastomoses with a 30° fetoscope in severe mid-trimester twin–twin transfusion syndrome with anterior placenta. Ultrasound Obstet Gynecol, 31: 412–416. doi: 10.1002/uog.5283
- Issue published online: 28 MAR 2008
- Article first published online: 10 MAR 2008
- Manuscript Accepted: 7 DEC 2007
- 30° fetoscope;
- anterior placenta;
- fetoscopic laser coagulation;
- intrauterine therapy;
- twin-twin transfusion syndrome
To assess outcome after fetoscopic laser coagulation (FLC) of placental vascular anastomoses with the 30° fetoscope in mid-trimester severe twin-to-twin transfusion syndrome (TTTS) with completely anterior placenta compared with the regular 0° fetoscope in TTTS with other placental locations.
This was a prospective study of 176 consecutive monochorionic twin pregnancies undergoing FLC for severe TTTS. Of these, 51 patients required use of the 30° fetoscope (study group) and 125 placental locations permitted use of the 0° fetoscope (controls).
The two groups had very similar outcomes. The median gestational age at FLC in the study group vs. control group was 21.0 (range, 17.4–24.6) weeks vs. 20.6 (range, 15.9–24.6) weeks. Both fetuses survived in 58.8% (30/51) of study patients vs. 66.4% (83/125) of controls. At least one fetus survived in 84.3% (43/51) of study patients and 88.8% (111/125) of controls (P = 0.45). Study patients delivered at a median of 34.1 (range, 25.0–38.4) weeks and controls at 34.0 (range, 25.0–40.3) weeks' gestation.
Use of a 30° fetoscope for FLC in cases of technically challenging extensive anterior placentation is associated with an outcome that is very similar to that achieved when a 0° fetoscope is used in cases of more favorable placental location. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.