Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 4 , Pages 294-301, December 2006

Fetoscopic Laser Therapy for Twin-Twin Transfusion Syndrome

  • Yao-Lung Chang

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Yao-Lung Chang, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Shin Street, Kweishan, Tao-Yuan 333, Taiwan

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan

Accepted 27 July 2006.

Article Outline

Summary

Twin-twin transfusion syndrome (TTTS) complicates approximately 1 in 5 of all monochorionic, diamniotic twin pregnancies. If of early onset and untreated, severe TTTS is associated with a dismal prognosis, with perinatal mortality rates exceeding 90%. The most controversial issue regarding the optimal treatment of TTTS has centered on the use of amniocentesis or laser until the first and only randomized trial on interventions for TTTS was published a couple of years ago, comparing laser to amnioreduction. That report confirmed that the laser group had a higher likelihood of the survival of at least one twin to 28 days of age and to 6 months of age. Infants in the laser group also had a lower incidence of cystic periventricular leukomalacia and were more likely to be free of neurologic complications at 6 months of age (52% vs. 31%, p = 0.003). Although not every case of TTTS is an eligible candidate for fetoscopic-guided laser therapy, it is recommended that obstetricians who have the chance to manage TTTS in their daily practice be familiar with the rationale behind this laser treatment for TTTS.

Key Words:  amnioreduction , fetoscope , laser therapy , twin-twin transfusion syndrome

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PII: S1028-4559(09)60246-1

doi:10.1016/S1028-4559(09)60246-1

Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 4 , Pages 294-301, December 2006

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