Abstract | BACKGROUND: METHODS: We performed intrauterine surgery in 45 pregnant women carrying twins at 15 to 28 weeks of gestation (median, 21); in each case there was severe hydramnios in one fetus due to the twin-twin transfusion syndrome. With the use of local anesthesia and continuous ultrasound visualization, a rigid fetoscope 2 mm in diameter, housed in a 2.7-mm cannula, was introduced transabdominally into the amniotic cavity of the recipient twin. A systematic search was made for all vessels approaching or crossing the membrane between the twins, and these were coagulated with an Nd:YAG laser by means of a fiber in the side arm of the cannula. RESULTS: Coagulation of the communicating vessels was successful in all cases. The total number of fetuses who survived to delivery was 48 (53 percent), and the number of pregnancies with at least 1 survivor was 32 (71 percent). Among the live-born infants, the median gestational age at delivery was 35 weeks (range, 25 to 40), and the median birth weight was 2098 g (range, 550 to 4252). The median interval between the endoscopic laser procedure and delivery was 14 weeks (range, 0 to 21). All the survivors were developing normally at a median age of 12 months (range, 2 to 24). CONCLUSIONS:
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Authors | Y Ville, J Hyett, K Hecher, K Nicolaides |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 332
Issue 4
Pg. 224-7
(Jan 26 1995)
ISSN: 0028-4793 [Print] United States |
PMID | 7808488
(Publication Type: Journal Article)
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Topics |
- Endoscopy
- Female
- Fetal Death
- Fetofetal Transfusion
(diagnostic imaging, surgery)
- Gestational Age
- Humans
- Infant, Newborn
- Laser Coagulation
(methods)
- Placenta
(blood supply)
- Pregnancy
- Pregnancy Outcome
- Pregnancy, Multiple
- Ultrasonography, Prenatal
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