Lenclen Richard, Paupe Alain, Ciarlo Giuseppina, Couderc Sophie, Castela Florence, Ortqvist Lisa, Ville Yves
Department of Neonatology, Paris-Ouest University, CHI Poissy-St-Germain, France.
Am J Obstet Gynecol. 2007 May;196(5):450.e1-7. doi: 10.1016/j.ajog.2007.01.036.
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.
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.
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.
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.
本研究旨在比较经羊水减量术或胎儿镜激光手术（FLS）治疗的双胎输血综合征（TTTS）早产新生儿与出生时孕周匹配的双绒毛膜新生儿的新生儿结局。
对137例主要接受羊水减量术（n = 36）或FLS（n = 101）治疗的TTTS早产新生儿的新生儿结局进行评估，并与在我们中心妊娠24 - 34周分娩的双绒毛膜双胎（n = 242）进行比较。
羊水减量术组不良新生儿结局（死亡或严重脑损伤）比FLS组和双绒毛膜组更常见。FLS组和双绒毛膜组婴儿的总体新生儿结局相当。然而，孕周<30周的FLS新生儿的新生儿发病率较高，主要与激光治疗失败有关。
在早产TTTS病例中，新生儿发病率随孕周增加以及FLS成功后独立降低。羊水减量术组以及激光治疗失败的病例中，TTTS特有的新生儿发病率较高。
