title: [Fetoscopic laser coagulation in 200 consecutive monochorionic pregnancies with twin-twin transfusion syndrome].
abstract: OBJECTIVE
  To report preoperative data, surgical characteristics, complications and perinatal outcome of twin-twin transfusion syndrome (TTTS) managed with laser ablation surgery, to analyze predictors of neonatal survival and to compare the 100 most recent cases with the older 100.
  
  
  METHODS
  Observational cohort moncentric study of 200 cases of TTTS consecutively treated with fetoscopic laser coagulation between January 2004 and December 2014.
  
  
  RESULTS
  There were 49 stage I, 88 stage II, 55 stage III and eight stage IV. Median gestation at time of laser was 20.1±3.0 weeks' gestation (WG) whereas median gestation at delivery was 31.6±5.4 WG. Overall perinatal survival rate was 68.0% and 84.0% have one or more surviving twins. Preterm premature rupture of membranes occurred in 39 cases with and the median gestational age for this complication was 28.8±4.6 SA. Predictive factors to have at least one living birth were Quintero stage and gestational age at delivery. In the most recent period, there were significantly more TTTS Quintero stage I treated with laser, more coagulation by the Solomon technique and a larger number of coagulated vessels.
  
  
  CONCLUSIONS
  The neonatal survival of TTTS is improved by fetoscopic laser coagulation, preferely by using Solomon tecnhique. The use of active management of stage I is currently on research.
authors.affiliation: Pôle de gynécologie-obstétrique, département d'échographie et de médecine fœtale, CMCO-HUS, 19, rue Louis-Pasteur, 67300 Schiltigheim/Strasbourg, France; Pôle de gynécologie-obstétrique, département d'obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: liselecointre@hotmail.fr.
authors.forename: L
authors.initials: L
authors.lastname: Lecointre
authors.affiliation: Pôle de gynécologie-obstétrique, département d'échographie et de médecine fœtale, CMCO-HUS, 19, rue Louis-Pasteur, 67300 Schiltigheim/Strasbourg, France; Pôle de gynécologie-obstétrique, département d'obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France; Inserm, UMR-S 1121, « Biomatériaux et Bioingénierie », 11, rue Humann, 67085 Strasbourg cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Sananès
authors.affiliation: Pôle de gynécologie-obstétrique, département d'échographie et de médecine fœtale, CMCO-HUS, 19, rue Louis-Pasteur, 67300 Schiltigheim/Strasbourg, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Weingertner
authors.affiliation: Pôle de gynécologie-obstétrique, département d'échographie et de médecine fœtale, CMCO-HUS, 19, rue Louis-Pasteur, 67300 Schiltigheim/Strasbourg, France; Pôle de gynécologie-obstétrique, département d'obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Gaudineau
authors.affiliation: Pôle de gynécologie-obstétrique, département d'obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Akladios
authors.affiliation: Pôle de gynécologie-obstétrique, département d'échographie et de médecine fœtale, CMCO-HUS, 19, rue Louis-Pasteur, 67300 Schiltigheim/Strasbourg, France.
authors.forename: V
authors.initials: V
authors.lastname: Cavillon
authors.affiliation: Pôle de gynécologie-obstétrique, département d'obstétrique, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Langer
authors.affiliation: Pôle de gynécologie-obstétrique, département d'échographie et de médecine fœtale, CMCO-HUS, 19, rue Louis-Pasteur, 67300 Schiltigheim/Strasbourg, France.
authors.forename: R
authors.initials: R
authors.lastname: Favre
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005330:Fetofetal Transfusion / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome; D014430:Twins, Monozygotic / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Coagulation laser fœtoscopique; Fetoscopic laser therapy; Grossesses monochoriales; Monochorionic twins; Syndrome transfuseur-transfusé; Twin-twin transfusion syndrome