Fetoscopic laser photocoagulation in the management of twin-twin transfusion syndrome: local experience from Hong Kong.

Abstract

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.

• Authors: X Yang, T Y Leung, Warwick D Ngan Kee, M Chen, L W Chan, T K Lau
• Journal: Hong Kong medical journal = Xianggang yi xue za zhi (Hong Kong Med J) Vol. 16 Issue 4 Pg. 275-81 (Aug 2010) ISSN: 1024-2708 [Print] China
• PMID: 20683070 (Publication Type: Journal Article)

Topics

• Female
• Fetofetal Transfusion (surgery)
• Fetoscopy (adverse effects, methods)
• Gestational Age
• Hong Kong
• Hospitals, University
• Humans
• Infant, Newborn
• Laser Coagulation (adverse effects, methods)
• Postoperative Complications
• Pregnancy
• Pregnancy Outcome
• Retrospective Studies
• Survival Rate
• Twins, Monozygotic
• Uterine Hemorrhage (etiology)