Rejoinder to meta-analysis of twin-twin transfusion by Skupski et al.
Assessment of treatment options in twin-twin transfusion should involve a detailed interrogation of the placenta and fetuses prior to treatment, stratification according to response to amnioreduction and careful analysis of quality of survival. Amnioreduction and laser coagulation are not alternative and equivalent modalities for the treatment of twin-twin transfusion. Randomized trials may not be ethical without prior therapeutic/diagnostic amnioreduction.
Machin
Geoffrey A
GA
The Permanente Medical Group, Oakland, California 94611, USA. Geoffrey.Machin@ncal.kaiperm.org
D000650:Amnion / Q000601:surgery; D004200:Diseases in Twins; D005260:Female; D005330:Fetofetal Transfusion / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome