TY - JOUR
T1 - Comparison between laparoscopically assisted and standard fetoscopic laser ablation in patients with anterior and posterior placentation in twin-twin transfusion syndrome
T2 - A single center study
AU - Shamshirsaz, Alireza A.
AU - Javadian, Pouya
AU - Ruano, Rodrigo
AU - Haeri, Sina
AU - Sangi-Haghpeykar, Haleh
AU - Lee, Timothy C.
AU - Molohon, Jayme
AU - Cass, Darrell L.
AU - Salmanian, Bahram
AU - Mollett, Laura
AU - Moaddab, Amirhossein
AU - Espinosa, Jimmy
AU - Olutoye, Oluyinka O.
AU - Belfort, Michael A.
N1 - Publisher Copyright:
© 2015 John Wiley & Sons, Ltd.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background: The objective of our study was to compare outcomes following laparoscopically assisted procedure (LAP group) with those seen following a standard approach used in patients with either an anterior placenta (SAP group) or posterior placenta (SPP group). Method: This was a retrospective review of all the cases of twin-twin transfusion syndrome treated in our fetal center from October 2011 to July 2013. Technical characteristics of the procedure, perinatal survival outcome, and maternal morbidity were compared. Results: The laser procedure time was significantly longer in the SAP group (44±10min) in contrast with SPP (19.3±13.9min, p<0.001) and LAP group (32±11min, p: 0.012). Preterm premature rupture of membranes (PPROM) before 32 and 34weeks of pregnancy was significantly more common with LAP versus SAP and SPP (90 vs 33.3 and 70.8% for 32weeks respectively, p: 0.015; 100 vs 50 and 79.1% for 34weeks respectively, p: 0.021). In terms of maternal morbidity and neonatal outcome, there were no significant differences between the three groups. Conclusion: LAP may be useful in cases where SAP is not feasible. Despite the increased risk of PPROM with LAP, perinatal survival and maternal outcomes are similar to that seen in SAP and SPP patients.
AB - Background: The objective of our study was to compare outcomes following laparoscopically assisted procedure (LAP group) with those seen following a standard approach used in patients with either an anterior placenta (SAP group) or posterior placenta (SPP group). Method: This was a retrospective review of all the cases of twin-twin transfusion syndrome treated in our fetal center from October 2011 to July 2013. Technical characteristics of the procedure, perinatal survival outcome, and maternal morbidity were compared. Results: The laser procedure time was significantly longer in the SAP group (44±10min) in contrast with SPP (19.3±13.9min, p<0.001) and LAP group (32±11min, p: 0.012). Preterm premature rupture of membranes (PPROM) before 32 and 34weeks of pregnancy was significantly more common with LAP versus SAP and SPP (90 vs 33.3 and 70.8% for 32weeks respectively, p: 0.015; 100 vs 50 and 79.1% for 34weeks respectively, p: 0.021). In terms of maternal morbidity and neonatal outcome, there were no significant differences between the three groups. Conclusion: LAP may be useful in cases where SAP is not feasible. Despite the increased risk of PPROM with LAP, perinatal survival and maternal outcomes are similar to that seen in SAP and SPP patients.
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U2 - 10.1002/pd.4552
DO - 10.1002/pd.4552
M3 - Article
C2 - 25559783
AN - SCOPUS:84926215778
SN - 0197-3851
VL - 35
SP - 376
EP - 381
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 4
ER -