title: Stage-related outcome after fetoscopic laser ablation in twin-to-twin transfusion syndrome.
abstract: OBJECTIVE
  To review the perinatal outcome of twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser coagulation in a developing country with detailed analysis according to the stage of the syndrome.
  
  
  METHODS
  This was a retrospective study of 85 TTTS cases treated with fetoscopic laser coagulation at the Fetal Diagnosis and Treatment Unit of Istanbul Faculty of Medicine between January 2006 and March 2013.
  
  
  RESULTS
  The surgical failure rate was 5.8% (5/85). Among all the cases of the total cohort, only 1 fetus survived in 27 pregnancies (31.8%), and both fetuses survived in 22 pregnancies (25.9%). In 49 pregnancies (57.6%) at least one fetus survived at the end of the neonatal period. The overall survival and live birth rates were 41.8% (71/170) and 56.4% (96/170), respectively, and they significantly decreased as the stage of disease increased. Delivery occurred before 32 weeks of gestation in 54 (63.5%) pregnancies. Logistic regression analysis showed that gestational age at delivery was the only independent factor, and the risk of nonsurvival significantly decreased with increasing age.
  
  
  CONCLUSIONS
  Based on our experience, the outcome of fetoscopic laser coagulation of the placental anastomoses for TTTS became worse as the Quintero stage of the disease advanced.
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Has
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Kalelioglu
authors.forename: Aytul
authors.initials: A
authors.lastname: Corbacioglu Esmer
authors.forename: Hayri
authors.initials: H
authors.lastname: Ermis
authors.forename: Ozlem
authors.initials: O
authors.lastname: Dural
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Dogan
authors.forename: Cenk
authors.initials: C
authors.lastname: Yasa
authors.forename: Harika
authors.initials: H
authors.lastname: Yumru
authors.forename: Omer
authors.initials: O
authors.lastname: Demir
authors.forename: Atil
authors.initials: A
authors.lastname: Yuksel
authors.forename: Lemi
authors.initials: L
authors.lastname: Ibrahimoglu
authors.forename: Alkan
authors.initials: A
authors.lastname: Yildirim
mesh_terms: D018450:Disease Progression; D005260:Female; D005330:Fetofetal Transfusion / Q000473:pathology / Q000601:surgery*; D005332:Fetoscopy; D006801:Humans; D053685:Laser Therapy; D016015:Logistic Models; D011247:Pregnancy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey