Hong Kong medical journal = Xianggang yi xue za zhi · 2010
Fetoscopic laser photocoagulation in the management of twin-twin transfusion syndrome: local experience from Hong Kong.
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Yang X, Leung T Y, Ngan Kee Warwick D, Chen M, Chan L W, Lau T K
Аннотация
OBJECTIVE: To review the perinatal outcome of monochorionic twin pregnancies treated by fetoscopic laser coagulation for twin-twin transfusion syndrome.
DESIGN: Retrospective study.
SETTING: A university teaching hospital in Hong Kong.
PATIENTS: Thirty consecutive cases of fetoscopic laser coagulation of placental anastomoses for twin-twin transfusion syndrome performed in a single centre.
MAIN OUTCOME MEASURES: Operative complications and perinatal survival rates.
RESULTS: The median gestational age at initial presentation, laser photocoagulation, and delivery were 22 (range, 16-27) weeks, 23 (18-28) weeks, and 32 (21-37) weeks, respectively. To improve the visualisation, in three cases amnio-exchange was undertaken; the procedure was abandoned in two due to poor visualisation. The overall fetal survival rate, the double infant survival rate, and survival rate for at least one twin were 72% (43/60), 60% (18/30), and 83% (25/30), respectively. The most common peri-operative complication was bleeding from the uterine wall into the amniotic cavity, which affected three (10%) patients.
CONCLUSIONS: Our results of fetoscopic laser surgery for twin-twin transfusion syndrome were similar to those in specialised centres in other countries.
DESIGN: Retrospective study.
SETTING: A university teaching hospital in Hong Kong.
PATIENTS: Thirty consecutive cases of fetoscopic laser coagulation of placental anastomoses for twin-twin transfusion syndrome performed in a single centre.
MAIN OUTCOME MEASURES: Operative complications and perinatal survival rates.
RESULTS: The median gestational age at initial presentation, laser photocoagulation, and delivery were 22 (range, 16-27) weeks, 23 (18-28) weeks, and 32 (21-37) weeks, respectively. To improve the visualisation, in three cases amnio-exchange was undertaken; the procedure was abandoned in two due to poor visualisation. The overall fetal survival rate, the double infant survival rate, and survival rate for at least one twin were 72% (43/60), 60% (18/30), and 83% (25/30), respectively. The most common peri-operative complication was bleeding from the uterine wall into the amniotic cavity, which affected three (10%) patients.
CONCLUSIONS: Our results of fetoscopic laser surgery for twin-twin transfusion syndrome were similar to those in specialised centres in other countries.