Incidence of complications in twin-twin transfusion syndrome after selective fetoscopic laser photocoagulation: a single-center experience.
OBJECTIVE
The purpose of this study was to evaluate the incidence of complications after selective fetoscopic laser photocoagulation for twin-twin transfusion syndrome (TTTS).


METHODS
One hundred fifty-two cases of TTTS were treated with selective fetoscopic laser photocoagulation from 2005-2008. Complications were TTTS recurrence, amniotic band syndrome, iatrogenic monoamnionicity, and twin anemia-polycythemia sequence. Data were placed in the following categories: no complications; early complications < or =7 days; late complications >7 days; both early and late complications.


RESULTS
The incidence of early, late, and both early and late complications was 31%, 39%, and 10%. Complications included 2 cases (1.3%) of monoamnionicity, 3 cases (2.0%) of recurrent TTTS, 3 cases (2.0%) of twin anemia-polycythemia sequence, and 5 cases (3.3%) of amniotic band syndrome. Cases with TTTS with early complications had a lower number of superficial arteriovenous vascular anastomoses and 1 or both fetus survival (70.2% vs 96.7%; P < .001), compared with no complications. Fetal survival was 238 of 307 cases (77.5%), with 1 or both twins surviving in 134 of 152 (88%) of pregnancies.


CONCLUSIONS
The incidence of early, late, and both early and late complications was 31%, 39%, and 10%, respectively. Close postoperative surveillance is important.
Habli
Mounira
M
The Fetal Care Center of Cincinnati, Cincinnati, OH, USA.
Bombrys
Annette
A
Lewis
David
D
Lim
Foong-Yen
FY
Polzin
William
W
Maxwell
Rose
R
Crombleholme
Timothy
T
D000652:Amniotic Band Syndrome / Q000453:epidemiology; D005260:Female; D005330:Fetofetal Transfusion / Q000150:complications* / Q000601:surgery*; D005332:Fetoscopy; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D017075:Laser Coagulation; D011086:Polycythemia / Q000453:epidemiology; D011247:Pregnancy; D012008:Recurrence