title: Stage-based outcomes of 682 consecutive cases of twin-twin transfusion syndrome treated with laser surgery: the USFetus experience.
abstract: OBJECTIVE
  We sought to describe stage-specific perinatal outcomes after selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome.
  
  
  METHODS
  Patients with twin-twin transfusion syndrome underwent SLPCV preferentially using sequential vs standard laser technique. Patient characteristics and outcome data were examined by Quintero stage.
  
  
  RESULTS
  Of 682 consecutive women studied, the Quintero stage distribution was: 114 stage I (17%), 177 stage II (26%), 328 stage III (48%), and 63 stage IV (9%). Perinatal survival of at least 1 twin did not differ according to stage (I-92%, II-93%, III-88%, IV-92%; P = .30). However, dual twin survival differed by stage (I-79%, II-76%, III-59%, IV-68%; P < .01), primarily because stage III pregnancies were associated with decreased donor twin survival (P < .01). Sequential SLPCV was associated with improved donor survival, independent of stage (odds ratio, 1.67; 95% confidence interval, 1.16-2.40; P < .01).
  
  
  CONCLUSIONS
  Stage-specific perinatal outcomes after laser therapy may assist physicians in patient counseling and in planning future studies.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, USA.
authors.forename: Ramen H
authors.initials: RH
authors.lastname: Chmait
authors.forename: Eftichia V
authors.initials: EV
authors.lastname: Kontopoulos
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Korst
authors.forename: Arlyn
authors.initials: A
authors.lastname: Llanes
authors.forename: Ileana
authors.initials: I
authors.lastname: Petisco
authors.forename: Rubén A
authors.initials: RA
authors.lastname: Quintero
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008875:Middle Aged; D011247:Pregnancy; D016896:Treatment Outcome