Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell College of Medicine, New York, NY, USA.
Am J Obstet Gynecol. 2010 Oct;203(4):388.e1-388.e11. doi: 10.1016/j.ajog.2010.06.018. Epub 2010 Aug 9.
To determine preoperative predictive factors for donor and recipient death after laser ablation of placental vessels in twin-to-twin transfusion syndrome.
Retrospective analysis of North American Fetal Therapy Network center laser procedures, 2002-2009. Factors associated with donor and recipient death were identified by regression analysis.
There were 466 patients from 8 centers. Factors significantly associated with donor fetal death were low donor estimated fetal weight (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.55-0.87) and reversed end diastolic velocity in the umbilical artery (OR, 4.0; 95% CI, 1.54-10.2); for recipient fetal death-low recipient estimated fetal weight (OR, 0.65; 95% CI, 0.44-0.95), recipient reversed "a" wave in the ductus venosus (OR, 2.39; 95% CI, 1.27-4.51) and hydrops (OR, 3.7; 95% CI, 1.1-12.7); for recipient neonatal death-low donor estimated fetal weight (OR, 0.54; 95% CI, 0.30-0.95), high recipient estimated fetal weight (OR, 1.55; 95% CI, 1.06-2.26) and recipient reversed end diastolic velocity in the umbilical artery (OR, 7.8; 95% CI, 1.03-59.3).
Preoperative findings predict fetal and neonatal demise in twin-to-twin transfusion syndrome treated with laser therapy.
确定激光消融胎盘血管治疗双胎输血综合征后供体和受体死亡的术前预测因素。
回顾性分析北美胎儿治疗网络中心的激光手术，时间为 2002 年至 2009 年。通过回归分析确定与供体和受体死亡相关的因素。
8 个中心的 466 名患者。与供体胎儿死亡显著相关的因素是低供体估计胎儿体重（比值比[OR]，0.69；95%置信区间[CI]，0.55-0.87）和脐动脉舒张末期反向血流（OR，4.0；95% CI，1.54-10.2）；与受体胎儿死亡显著相关的因素是低受体估计胎儿体重（OR，0.65；95% CI，0.44-0.95）、受体静脉导管反向“a”波（OR，2.39；95% CI，1.27-4.51）和水肿（OR，3.7；95% CI，1.1-12.7）；与受体新生儿死亡显著相关的因素是低供体估计胎儿体重（OR，0.54；95% CI，0.30-0.95）、高受体估计胎儿体重（OR，1.55；95% CI，1.06-2.26）和脐动脉舒张末期反向血流（OR，7.8；95% CI，1.03-59.3）。
激光治疗治疗双胎输血综合征后，术前发现可预测胎儿和新生儿死亡。
