胎儿镜激光光凝术（FLP）治疗双胎输血综合征（TTTS）的母体并发症。

Maternal complications of fetoscopic laser photocoagulation (FLP) for treatment of twin-twin transfusion syndrome (TTTS).

机构信息

Department of Obstetrics and Prenatal Medicine, University of Bonn Medical School, Bonn, Germany.

出版信息

J Perinat Med. 2010 Jul;38(4):439-43. doi: 10.1515/jpm.2010.061.

DOI:10.1515/jpm.2010.061

PMID:20184399

Abstract

AIMS

Fetoscopic laser photocoagulation (FLP) has become standard therapy for severe twin-twin transfusion syndrome. Data on adverse maternal events are rare. We performed a literature review to obtain data on maternal complications of FLP.

METHODS

Extensive literature review, searching MEDLINE and other databases from 1990 to 2009, using MESH-terms and further keywords. Data extraction was performed using the following criteria: (i) maternal complications reported as primary or secondary outcome parameters; (ii) any comment on adverse maternal events.

RESULTS

Of 321 publications found 40 were included, comprising 1785 patients. The overall rate of adverse maternal events was 5.4%. In studies with systematic assessment (n=3, 379 patients) the complication rate was significantly higher (17.4% vs. 2.2%, P<0.0001). Adverse events were classified and the rate was 1.0% (1.8% vs. 0.8%, P=0.12) for severe complications; 2.9% (11.9% vs. 0.5%, P<0.0001) for intermediate/minor adverse events; and 1.5% (3.7% vs. 0.9%, P<0.0001) for complications with undetermined relevance.

CONCLUSIONS

High-quality data on maternal complications of FLP are rare. With systematic assessment, the rate of adverse events is significantly higher. Underreporting has to be assumed. Further studies are required to confirm these data.

摘要

目的

胎儿镜激光凝固术（FLP）已成为严重双胎输血综合征的标准治疗方法。关于母体不良事件的数据很少。我们进行了文献复习，以获得 FLP 产妇并发症的数据。

方法

广泛的文献回顾，使用 MESH 术语和其他关键字，从 1990 年到 2009 年在 MEDLINE 和其他数据库中进行搜索。使用以下标准提取数据：（i）报告为主要或次要结局参数的产妇并发症；（ii）对不良母体事件的任何评论。

结果

在 321 篇已发表的论文中，有 40 篇被纳入，共包括 1785 名患者。总体不良母体事件发生率为 5.4%。在有系统评估的研究中（n=3,379 例），并发症发生率显著更高（17.4% vs. 2.2%，P<0.0001）。将不良事件进行分类，严重并发症的发生率为 1.0%（1.8% vs. 0.8%，P=0.12）；中度/轻度不良事件的发生率为 2.9%（11.9% vs. 0.5%，P<0.0001）；不确定相关的并发症发生率为 1.5%（3.7% vs. 0.9%，P<0.0001）。