title: Outcomes in a cohort of patients with Stage I twin-to-twin transfusion syndrome.
abstract: OBJECTIVE
  To determine pregnancy outcomes of patients who present with Stage I twin-to-twin transfusion syndrome (TTTS).
  
  
  METHODS
  This was a retrospective review of all patients with TTTS referred to our institution between January 2005 and December 2006. Quintero criteria were used for staging. Laser ablation was not offered to patients with Stage I disease.
  
  
  RESULTS
  A total of 155 twin pregnancies were evaluated for TTTS during this period. Forty-two met the criteria for Stage I and were included in the analysis. The overall survival to discharge was 82%. The mean gestational age at the time of consultation was 20.9 +/- 0.4 weeks. A total of 23 cases (54.8%) underwent amnioreduction. Progression of TTTS requiring invasive therapy occurred in four cases. The mean gestational age at delivery was 32.5 +/- 0.62 weeks. When divided according to use of amnioreduction, there were no statistically significant differences between the groups for gestational age at delivery or for birth weight. Those Stage I cases with a CHOP cardiovascular score of 5 or higher delivered almost 3 weeks earlier than the remainder of the cohort.
  
  
  CONCLUSIONS
  Progression of TTTS beyond Stage I occurred in only 9.5% of the cohort. Mean gestational age at delivery and survival to discharge did not differ between Stage I patients and those treated with placental laser ablation for more advanced stages of TTTS.
authors.affiliation: Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA. bebbington@email.chop.edu
authors.forename: M W
authors.initials: MW
authors.lastname: Bebbington
authors.forename: E
authors.initials: E
authors.lastname: Tiblad
authors.forename: M
authors.initials: M
authors.lastname: Huesler-Charles
authors.forename: R D
authors.initials: RD
authors.lastname: Wilson
authors.forename: S E
authors.initials: SE
authors.lastname: Mann
authors.forename: M P
authors.initials: MP
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001724:Birth Weight; D018450:Disease Progression; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D014427:Twins; D014463:Ultrasonography