title: Maternal complications of fetoscopic laser photocoagulation (FLP) for treatment of twin-twin transfusion syndrome (TTTS).
abstract: Fetoscopic laser photocoagulation (FLP) has become standard therapy for severe twin-twin transfusion syndrome. Data on adverse maternal events are rare. We performed a literature review to obtain data on maternal complications of FLP.
  
  
  
  Extensive literature review, searching MEDLINE and other databases from 1990 to 2009, using MESH-terms and further keywords. Data extraction was performed using the following criteria: (i) maternal complications reported as primary or secondary outcome parameters; (ii) any comment on adverse maternal events.
  
  
  
  Of 321 publications found 40 were included, comprising 1785 patients. The overall rate of adverse maternal events was 5.4%. In studies with systematic assessment (n=3, 379 patients) the complication rate was significantly higher (17.4% vs. 2.2%, P<0.0001). Adverse events were classified and the rate was 1.0% (1.8% vs. 0.8%, P=0.12) for severe complications; 2.9% (11.9% vs. 0.5%, P<0.0001) for intermediate/minor adverse events; and 1.5% (3.7% vs. 0.9%, P<0.0001) for complications with undetermined relevance.
  
  
  
  High-quality data on maternal complications of FLP are rare. With systematic assessment, the rate of adverse events is significantly higher. Underreporting has to be assumed. Further studies are required to confirm these data.
authors.affiliation: Department of Obstetrics and Prenatal Medicine, University of Bonn Medical School, Bonn, Germany. Waltraut.Merz@ukb.uni-bonn.de
authors.forename: Waltraut
authors.initials: W
authors.lastname: Merz
authors.forename: Kristina
authors.initials: K
authors.lastname: Tchatcheva
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gembruch
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohl
mesh_terms: D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects*; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012449:Safety