title: Future Directions in the Management of Twin-to-Twin Transfusion Syndrome.
abstract: Twin-to-twin transfusion syndrome (TTTS) is the major complication of monochorionic (MC) pregnancy. The outcomes of this condition have been significantly improved after the introduction and widespread uptake of fetoscopic laser ablation over the last decade. However, there is still a significant fetal loss rate and morbidity associated with this condition. Improvements in the management of TTTS will require improvements in many areas. They are likely to involve refinements in the prediction of the disease and clarification of the optimum frequency of surveillance and monitoring. Improvements in training for fetoscopic surgery as well as in the technique of fetoscopic laser ablation may lead to better outcomes. New technologies as well as a better understanding of the pathophysiology of TTTS may lead to adjuvant medical therapies that may also improve short- and long-term results.
authors.affiliation: Queensland Ultrasound for Women,Brisbane,Queensland,Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Cincotta
authors.affiliation: Department of Maternal Fetal Medicine,Mater Mothers' Hospital,Brisbane,Queensland,Australia.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D019468:Disease Management; D005260:Female; D005330:Fetofetal Transfusion / Q000503:physiopathology / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects*; D005333:Fetus / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects*; D010920:Placenta / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery; D011247:Pregnancy; D059285:Pregnancy, Twin
keywords: Twin-to-twin transfusion syndrome; laser therapy; monochorionic twins; review