Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies

Ranjit Akolekar

doi:10.1159/000443792

Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies

Ranjit Akolekar

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To report outcome of monochorionic (MC) and dichorionic (DC) triamniotic (TA) triplet pregnancies treated with endoscopic laser coagulation of communicating placental vessels for severe fetofetal transfusion syndrome (FFTS) and selective fetal growth restriction (sFGR).

Methods: Laser surgery was performed at 18 (15-24) weeks gestation in 11 MCTA and 33 DCTA pregnancies complicated by FFTS and 14 DCTA pregnancies complicated by sFGR. Data from our study and previous reports were pooled using meta-analytic techniques.

Results: Survival of at least one baby and survival among all fetuses was 97.0% and 72.7% in DCTA pregnancies with FFTS, 78.6% and 52.4% in DCTA pregnancies with sFGR and 81.8% and 39.4% in MCTA pregnancies with FFTS. In the combined data from our study and previous reports, the pooled survival rates in 132 DCTA pregnancies with FFTS were 94.4% and 76.1% and in 29 MCTA pregnancies with FFTS were 80.6% and 57.5%.

Conclusions: Survival after laser surgery is higher in DC triplets with FFTS than those with sFGR and in DC than MC triplets with FFTS.

Original language	English
Pages (from-to)	174-180
Journal	Fetal Diagnosis and Therapy
Volume	40
Issue number	3
DOIs	https://doi.org/10.1159/000443792
Publication status	Published - 25 Feb 2016

Keywords

Dichorionic triplets
Endoscopic laser coagulation
Monochorionic triplets
Selective fetal growth restriction
Twin-to-twin transfusion syndrome

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4. Endoscopic Placental Laser Coagulation in Dichorionic and Monochorionic Triplet Pregnancies.pdfFinal published version, 251 KB

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title = "Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies",

abstract = "Objective: To report outcome of monochorionic (MC) and dichorionic (DC) triamniotic (TA) triplet pregnancies treated with endoscopic laser coagulation of communicating placental vessels for severe fetofetal transfusion syndrome (FFTS) and selective fetal growth restriction (sFGR). Methods: Laser surgery was performed at 18 (15-24) weeks gestation in 11 MCTA and 33 DCTA pregnancies complicated by FFTS and 14 DCTA pregnancies complicated by sFGR. Data from our study and previous reports were pooled using meta-analytic techniques. Results: Survival of at least one baby and survival among all fetuses was 97.0\% and 72.7\% in DCTA pregnancies with FFTS, 78.6\% and 52.4\% in DCTA pregnancies with sFGR and 81.8\% and 39.4\% in MCTA pregnancies with FFTS. In the combined data from our study and previous reports, the pooled survival rates in 132 DCTA pregnancies with FFTS were 94.4\% and 76.1\% and in 29 MCTA pregnancies with FFTS were 80.6\% and 57.5\%. Conclusions: Survival after laser surgery is higher in DC triplets with FFTS than those with sFGR and in DC than MC triplets with FFTS.",

keywords = "Dichorionic triplets, Endoscopic laser coagulation, Monochorionic triplets, Selective fetal growth restriction, Twin-to-twin transfusion syndrome",

author = "Ranjit Akolekar",

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day = "25",

doi = "10.1159/000443792",

language = "English",

volume = "40",

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journal = "Fetal Diagnosis and Therapy",

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N2 - Objective: To report outcome of monochorionic (MC) and dichorionic (DC) triamniotic (TA) triplet pregnancies treated with endoscopic laser coagulation of communicating placental vessels for severe fetofetal transfusion syndrome (FFTS) and selective fetal growth restriction (sFGR). Methods: Laser surgery was performed at 18 (15-24) weeks gestation in 11 MCTA and 33 DCTA pregnancies complicated by FFTS and 14 DCTA pregnancies complicated by sFGR. Data from our study and previous reports were pooled using meta-analytic techniques. Results: Survival of at least one baby and survival among all fetuses was 97.0% and 72.7% in DCTA pregnancies with FFTS, 78.6% and 52.4% in DCTA pregnancies with sFGR and 81.8% and 39.4% in MCTA pregnancies with FFTS. In the combined data from our study and previous reports, the pooled survival rates in 132 DCTA pregnancies with FFTS were 94.4% and 76.1% and in 29 MCTA pregnancies with FFTS were 80.6% and 57.5%. Conclusions: Survival after laser surgery is higher in DC triplets with FFTS than those with sFGR and in DC than MC triplets with FFTS.

AB - Objective: To report outcome of monochorionic (MC) and dichorionic (DC) triamniotic (TA) triplet pregnancies treated with endoscopic laser coagulation of communicating placental vessels for severe fetofetal transfusion syndrome (FFTS) and selective fetal growth restriction (sFGR). Methods: Laser surgery was performed at 18 (15-24) weeks gestation in 11 MCTA and 33 DCTA pregnancies complicated by FFTS and 14 DCTA pregnancies complicated by sFGR. Data from our study and previous reports were pooled using meta-analytic techniques. Results: Survival of at least one baby and survival among all fetuses was 97.0% and 72.7% in DCTA pregnancies with FFTS, 78.6% and 52.4% in DCTA pregnancies with sFGR and 81.8% and 39.4% in MCTA pregnancies with FFTS. In the combined data from our study and previous reports, the pooled survival rates in 132 DCTA pregnancies with FFTS were 94.4% and 76.1% and in 29 MCTA pregnancies with FFTS were 80.6% and 57.5%. Conclusions: Survival after laser surgery is higher in DC triplets with FFTS than those with sFGR and in DC than MC triplets with FFTS.

KW - Dichorionic triplets

KW - Endoscopic laser coagulation

KW - Monochorionic triplets

KW - Selective fetal growth restriction

KW - Twin-to-twin transfusion syndrome

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DO - 10.1159/000443792

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JO - Fetal Diagnosis and Therapy

JF - Fetal Diagnosis and Therapy

IS - 3

ER -

Endoscopic placental laser coagulation in dichorionic and monochorionic triplet pregnancies

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