Fetoscopic laser photocoagulation in the management of twin-twin transfusion syndrome: local experience from Hong Kong.
OBJECTIVE
To review the perinatal outcome of monochorionic twin pregnancies treated by fetoscopic laser coagulation for twin-twin transfusion syndrome.


METHODS
Retrospective study.


METHODS
A university teaching hospital in Hong Kong.


METHODS
Thirty consecutive cases of fetoscopic laser coagulation of placental anastomoses for twin-twin transfusion syndrome performed in a single centre.


METHODS
Operative complications and perinatal survival rates.


RESULTS
The median gestational age at initial presentation, laser photocoagulation, and delivery were 22 (range, 16-27) weeks, 23 (18-28) weeks, and 32 (21-37) weeks, respectively. To improve the visualisation, in three cases amnio-exchange was undertaken; the procedure was abandoned in two due to poor visualisation. The overall fetal survival rate, the double infant survival rate, and survival rate for at least one twin were 72% (43/60), 60% (18/30), and 83% (25/30), respectively. The most common peri-operative complication was bleeding from the uterine wall into the amniotic cavity, which affected three (10%) patients.


CONCLUSIONS
Our results of fetoscopic laser surgery for twin-twin transfusion syndrome were similar to those in specialised centres in other countries.
Yang
X
X
Prenatal Diagnostic Centre, Guangzhou Obstetrics and Neonatal Hospital, Guangzhou, Guangdong, PR China.
Leung
T Y
TY
Ngan Kee
Warwick D
WD
Chen
M
M
Chan
L W
LW
Lau
T K
TK
D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects / Q000379:methods*; D005865:Gestational Age; D006723:Hong Kong; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D015996:Survival Rate; D014430:Twins, Monozygotic; D014592:Uterine Hemorrhage / Q000209:etiology