Laser therapy of twin-to-twin transfusion syndrome in triplet pregnancies.
OBJECTIVE
Laser coagulation of placental anastomoses in twin pregnancies complicated by severe twin-to-twin transfusion syndrome (TTTS) has been shown to be superior to serial amniodrainage, and has emerged as the standard therapy for this condition. We report the outcome of triplet pregnancies treated with laser therapy for severe TTTS.


METHODS
From a database containing information on all multiple pregnancies referred to our center we identified 20 triplet pregnancies with severe TTTS. Sixteen of them were dichorionic, four monochorionic and all cases were triamniotic. Perinatal outcome was obtained in all cases.


RESULTS
Fetoscopy was performed in 18 out of 20 cases at a median gestational age of 19.7 (range, 17.0-23.3) weeks. Delivery occurred at a median of 31.9 (range, 24.7-36.4) weeks with an overall fetal survival rate of 65%, at least one surviving fetus in 83% of cases and all three fetuses surviving in 39%.


CONCLUSIONS
Laser coagulation is an effective treatment for severe TTTS in triplets. However, survival rates are lower than in twin pregnancies.
Diemert
A
A
Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Diehl
W
W
Huber
A
A
Glosemeyer
P
P
Hecher
K
K
D016208:Databases, Factual; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D012720:Severity of Illness Index; D015996:Survival Rate; D014310:Triplets; D014463:Ultrasonography