Results of laser therapy in twin-to-twin transfusion syndrome: our experience.

OBJECTIVE

The authors of this paper present the results of laser treatment in twin-to-twin transfusion syndrome.

METHODS

Laser photocoagulation of communicating vessels was performed on 91 patients from April 2005 to June 2010, at the Medical University of Gdansk (Poland). Results of treatment were analyzed.

RESULTS

The following results were achieved: at least one survival at delivery in 71 patients (83.5%), two survivors in 49 women (57.6%), and an overall survival rate of 70.6%. After the inclusion of neonatal deaths, at least one survival was reported in 65 women (76.5%) - 30 with two survivors (44.7%) and 27 with one survivor (31.8%). The incidence of preterm rupture of membranes (4 cases - 4.3%), dual intrauterine fetal demise (7 cases - 7.4%) and miscarriage or delivery (8 cases - 8.5%) during the first week after surgery were the main reasons of pregnancy loss in the analyzed group. The frequency of cerebral palsy diagnosed after 6 months was 7%.

CONCLUSIONS

Despite a lower incidence of dual neonatal survivals than in other series, the results of the first years of experience with laser treatment of twin-twin transfusion syndrome are encouraging, and prompt us to improve our surgical skills to achieve better outcomes.