羊膜腔穿刺减压或胎儿镜激光手术宫内治疗后双绒毛膜双胎及单绒毛膜双胎双胎输血综合征的新生儿结局：与双绒毛膜双胎的比较

Neonatal outcome in preterm monochorionic twins with twin-to-twin transfusion syndrome after intrauterine treatment with amnioreduction or fetoscopic laser surgery: comparison with dichorionic twins.

作者信息

Lenclen Richard, Paupe Alain, Ciarlo Giuseppina, Couderc Sophie, Castela Florence, Ortqvist Lisa, Ville Yves

机构信息

Department of Neonatology, Paris-Ouest University, CHI Poissy-St-Germain, France.

出版信息

Am J Obstet Gynecol. 2007 May;196(5):450.e1-7. doi: 10.1016/j.ajog.2007.01.036.

DOI:10.1016/j.ajog.2007.01.036

PMID:17466697

Abstract

OBJECTIVE

The purpose of this study was to compare neonatal outcome in preterm neonates after twin-to-twin transfusion syndrome (TTTS) that was treated by amnioreduction or fetoscopic laser surgery (FLS) and in dichorionic neonates who were matched for gestational age at birth.

STUDY DESIGN

Neonatal outcome was assessed in 137 TTTS preterm neonates who were treated primarily with either amnioreduction (n = 36) or FLS (n = 101) and compared with dichorionic twins (n = 242) who were delivered at our center at 24-34 weeks of gestation.

RESULTS

Adverse neonatal outcome (death or severe cerebral lesions) was more frequent in the amnioreduction group than in the FLS and dichorionic groups. Overall neonatal outcome was comparable in FLS and dichorionic infants. However, neonatal morbidity was higher in FLS neonates at <30 weeks of gestation that was related mainly to failed laser therapy.

CONCLUSION

In preterm TTTS cases, neonatal morbidity decreases independently with gestational age and after successful FLS. Neonatal morbidity that was specific of TTTS was higher in the amnioreduction group and in cases with failed laser therapy.

摘要