title: Decrease in high human chorionic gonadotropin in twin-twin transfusion syndrome following fetoscopic laser surgery.
abstract: BACKGROUND
  The purpose of this study was to investigate the concentration of maternal serum human chorionic gonadotropin (hCG) in twin-twin transfusion syndrome (TTTS) before and after fetoscopic laser surgery and to clarify the association between TTTS and hCG.
  
  
  METHODS
  The concentration of maternal serum hCG was measured before fetoscopic laser surgery and 2 and 4 weeks after laser surgery in 120 patients diagnosed with TTTS.
  
  
  RESULTS
  The preoperative serum concentration of hCG was 6.34 multiples of the median (MoM; interquartile range 3.52-9.86). The concentration of hCG was higher in TTTS of Quintero stage III or IV (7.17 MoM, range 4.21-11.0) compared to stage I or II (3.37 MoM, range 2.35-7.74). When laser surgery for TTTS was effective, hCG gradually decreased to less than half the preoperative concentration 2 weeks after laser surgery, and the concentration was further reduced to within the normal range at 4 weeks. However, the concentration of hCG in 3 cases with TTTS recurrence did not decrease.
  
  
  CONCLUSIONS
  A close association was observed between the concentration of hCG and the condition of TTTS. A change in the concentration of hCG after laser surgery could be a useful marker to judge the effectiveness of laser surgery in TTTS.
authors.affiliation: Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan.
authors.forename: Masachi
authors.initials: M
authors.lastname: Hanaoka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hayashi
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Mineto
authors.initials: M
authors.lastname: Morita
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D005330:Fetofetal Transfusion / Q000097:blood* / Q000601:surgery; D005332:Fetoscopy; D006801:Humans; D011247:Pregnancy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin