title: Ultrasound prognostic factors after laser surgery for twin-twin transfusion syndrome to predict survival at 6 months.
abstract: OBJECTIVE
  To evaluate the significance of ultrasound findings, detected one or two weeks after laser surgery for twin-twin transfusion syndrome, in predicting the mortality at 6 months of age.
  
  
  METHODS
  Ultrasound evaluation including fetal biometry, amniotic fluid volume estimation and Doppler examination was performed between 7 and 14 days after surgery for 181 cases. The presence of one or more effusions and single fetal death were also determined. Associations between ultrasound findings and mortality at 6 months of age were evaluated using multiple logistic regression analysis.
  
  
  RESULTS
  Of the total 181 pairs, 145 (80.1%) donor and 160 (88.1%) recipient twins survived in utero for more than 7 days after surgery, and hence were included in the analysis. The survival rate at 6 months was 66.9% for the donor and 80.7% for the recipient twins. Risk factors for death in the donor were the presence of severe intrauterine growth restriction and effusions. In recipients, elevation in the middle cerebral artery peak systolic velocity coincided with fetal death, but this occurred in only three cases.
  
  
  CONCLUSIONS
  Ultrasound risk factors one week after surgery included severe intrauterine growth restrictions and effusions in the donor twins.
authors: Division of Perinatology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan. keisui@mch.pref.osaka.jp
authors: Keisuke
authors: K
authors: Ishii
authors: Mari
authors: M
authors: Saito
authors: Masahiko
authors: M
authors: Nakata
authors: Yuichiro
authors: Y
authors: Takahashi
authors: Satoshi
authors: S
authors: Hayashi
authors: Takeshi
authors: T
authors: Murakoshi
authors: Jun
authors: J
authors: Murotsuki
authors: Hiroshi
authors: H
authors: Kawamoto
authors: Haruhiko
authors: H
authors: Sago
mesh_terms: D000328:Adult; D005260:Female; D005330:Fetofetal Transfusion / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053685:Laser Therapy; D011183:Postoperative Complications; D011247:Pregnancy; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D016216:Ultrasonography, Prenatal