BJOG : an international journal of obstetrics and gynaecology · 2016
Fetal brain imaging following laser surgery in twin-to-twin surgery.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Stirnemann J, Chalouhi G, Essaoui M, Bahi-Buisson N, Sonigo P, Millischer A-E, Lapillonne A, Guigue V, Salomon L J, Ville Y
Аннотация
OBJECTIVE: To describe the incidence and nature of prenatal brain damage following fetoscopic laser selective coagulation (FLSC) of placental vessels for twin-to-twin transfusion syndrome (TTTS).
DESIGN: Retrospective observational study.
SETTING: Single center cohort.
POPULATION: All consecutive cases referred for TTTS treated by FLSC between 2003 and 2015.
METHODS: After the FLSC, patients were followed weekly by ultrasound. Fetal magnetic resonance imaging (MRI) scans were systematically planned at 30-32 weeks of gestation.
MAIN OUTCOME MEASURES: Brain damage diagnosed prenatally by ultrasound or MRI.
RESULTS: In total, 1023 cases were reviewed. Brain damage was diagnosed prenatally in 22/1023 (2.1%) cases. Diagnosis was performed by ultrasound prior to MRI in 18 (82%) cases. All lesions were within the spectrum of ischaemic haemorrhagic lesions. Postoperative twin anaemia polycythaemia sequence and recurrence of TTTS were significantly associated with brain damage.
CONCLUSION: The incidence of prenatal brain damage is low following FSLC, and is strongly associated with incomplete surgery.
TWEETABLE ABSTRACT: Following FSLC for TTTS, prenatal brain damage occurs in 2% of cases and is associated with incomplete surgery.
DESIGN: Retrospective observational study.
SETTING: Single center cohort.
POPULATION: All consecutive cases referred for TTTS treated by FLSC between 2003 and 2015.
METHODS: After the FLSC, patients were followed weekly by ultrasound. Fetal magnetic resonance imaging (MRI) scans were systematically planned at 30-32 weeks of gestation.
MAIN OUTCOME MEASURES: Brain damage diagnosed prenatally by ultrasound or MRI.
RESULTS: In total, 1023 cases were reviewed. Brain damage was diagnosed prenatally in 22/1023 (2.1%) cases. Diagnosis was performed by ultrasound prior to MRI in 18 (82%) cases. All lesions were within the spectrum of ischaemic haemorrhagic lesions. Postoperative twin anaemia polycythaemia sequence and recurrence of TTTS were significantly associated with brain damage.
CONCLUSION: The incidence of prenatal brain damage is low following FSLC, and is strongly associated with incomplete surgery.
TWEETABLE ABSTRACT: Following FSLC for TTTS, prenatal brain damage occurs in 2% of cases and is associated with incomplete surgery.