Wagner Marise M, Lopriore Enrico, Klumper Frans J, Oepkes Dick, Vandenbussche Frank P H A, Middeldorp Johanna M
Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Am J Obstet Gynecol. 2009 Sep;201(3):286.e1-6. doi: 10.1016/j.ajog.2009.05.034. Epub 2009 Jul 22.
We sought to compare short- and long-term outcome in Quintero stage 1 twin-to-twin transfusion syndrome (TTTS), managed with laser surgery or conservatively.
We conducted a retrospective study of all monochorionic twin pregnancies with stage 1 TTTS referred to our center. Primary outcomes were perinatal survival, neonatal morbidity, and long-term neurodevelopmental outcome.
Fifty women presented with stage 1 TTTS of which 40% (20/50) was treated with laser and 60% (30/50) was managed conservatively. Perinatal survival of both or at least 1 twin was 65% (13/20) and 85% (17/20) in the laser group, and 77% (23/30) and 97% (29/30) in the conservatively managed group (P = .52 and P = .29), respectively. Long-term neurodevelopmental impairment of the surviving infants was found in 0% (0/21) vs 23% (7/30), respectively (P = .03).
In this retrospective study, long-term outcome in stage 1 TTTS was better after laser surgery than with conservative management, suggesting the need for a randomized controlled trial.
我们试图比较采用激光手术或保守治疗的昆特罗1期双胎输血综合征（TTTS）的短期和长期结局。
我们对转诊至本中心的所有昆特罗1期TTTS单绒毛膜双胎妊娠进行了一项回顾性研究。主要结局指标为围产期存活率、新生儿发病率和长期神经发育结局。
50例患者出现昆特罗1期TTTS，其中40%（20/50）接受激光治疗，60%（30/50）接受保守治疗。激光治疗组中两个胎儿或至少一个胎儿的围产期存活率分别为65%（13/20）和85%（17/20），保守治疗组分别为77%（23/30）和97%（29/30）（P = 0.52和P = 0.29）。存活婴儿的长期神经发育障碍发生率分别为0%（0/21）和23%（7/30）（P = 0.03）。
在这项回顾性研究中，激光手术后昆特罗1期TTTS的长期结局优于保守治疗，提示需要进行一项随机对照试验。
