title: Neonatal outcome using ultrathin fetoscope for laser coagulation in twin-to-twin-transfusion syndrome.
abstract: To improve neonatal outcome using ultrathin fetoscope for laser treatment of twin-to-twin transfusion syndrome.
  
  
  
  Retrospective cohort study of a series of 80 cases of twin-to-twin-transfusion syndrome prior to 26-weeks' gestation subjected to laser coagulation by means of a 1.0/1.2 mm fiber fetoscope with a sheath sectional area 2.65 mm(2)/3.34 mm(2) (n=27) and a 2.0 mm classic lens fetoscope with a sheath sectional area: 6.63 mm(2)/11.27 mm(2) (n=53).
  
  
  
  The survival rates of at least one twin in the compared groups were 94.4% (classic optic) and 100% (ultrathin optic), for both twins: 75.5% and 83.3%, respectively. By decreasing sheath diameter a pregnancy was prolonged by an average of 21.3 days (P=0.0045), with a resulting increase in the recipient's weight of 389 g (P=0.0049) and an increase in the donor's Apgar score. However, the intervention with ultrathin optic took 11 min longer (P=0.031).
  
  
  
  The reduction of the iatrogenic damage of the amniotic membrane using ultrathin fetoscope with a small sheath, significantly improves the neonatal outcome after laser treatment of twin-to-twin-transfusion syndrome. The operator should only commence working with the 1 mm fetoscope after the learning curve has been accomplished.
authors.affiliation: University Clinic of Obstetrics and Fetal Medicine, University Medical Center Halle (Saale) of Martin Luther University of Halle-Wittenberg, Germany. michael.tchirikov@uk-halle.de
authors.forename: Michael
authors.initials: M
authors.lastname: Tchirikov
authors.forename: Viktor
authors.initials: V
authors.lastname: Oshovskyy
authors.forename: Joscha
authors.initials: J
authors.lastname: Steetskamp
authors.forename: Andreas
authors.initials: A
authors.lastname: Falkert
authors.forename: Georgine
authors.initials: G
authors.lastname: Huber
authors.forename: Michael
authors.initials: M
authors.lastname: Entezami
mesh_terms: D000328:Adult; D001163:Arteriovenous Anastomosis / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D020669:Fetoscopes; D005332:Fetoscopy / Q000379:methods; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000295:instrumentation* / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies