title: Fetoscopic laser therapy for twin-twin transfusion syndrome before 17 and after 26 weeks' gestation.
abstract: OBJECTIVE
  The purpose of this study was to compare perinatal outcomes of pregnancies that undergo "early" (<17 weeks' gestation) or "late" (>26 weeks' gestation) fetoscopic laser ablation of placental vascular anastomoses for twin-twin transfusion syndrome (TTTS) with "conventional" cases that were treated at 17-26 weeks' gestation.
  
  
  METHODS
  We conducted a single center, retrospective analysis of 325 consecutive pregnancies that underwent fetoscopic laser therapy for severe TTTS.
  
  
  RESULTS
  Twenty-four "early," 18 "late," and 283 "conventional" pregnancies with severe TTTS underwent laser therapy. Fetoscopy duration, gestation at delivery, survival rate, and complications were comparable among groups, except for preterm premature rupture of membranes at <7 days after laser therapy, which was more common in the "early" group than in either of the other 2 groups.
  
  
  CONCLUSIONS
  Laser therapy for TTTS at <17 or >26 weeks' gestation has similar outcomes to procedures done at 17-26 weeks' gestation. We suggest that conventional gestational age guidelines of 16-26 weeks for laser therapy for TTTS should be reevaluated.
authors.affiliation: Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Baud
authors.forename: Rory
authors.initials: R
authors.lastname: Windrim
authors.forename: Johannes
authors.initials: J
authors.lastname: Keunen
authors.forename: Edmond N
authors.initials: EN
authors.lastname: Kelly
authors.forename: Prakesh
authors.initials: P
authors.lastname: Shah
authors.forename: Tim
authors.initials: T
authors.lastname: van Mieghem
authors.forename: P Gareth R
authors.initials: PG
authors.lastname: Seaward
authors.forename: Greg
authors.initials: G
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D016896:Treatment Outcome