Weingertner A-S, Kohler A, Mager C, Miry C, Viville B, Kohler M, Hunsinger M-C, Hornecker F, Bouffet N, Trastour S, Neumann M, Roth F, Bartolomei C, Favre R
Département d'échographie et de médecine fœtale, pôle de gynécologie obstétrique, CMCO-SIHCUS, 19 rue Louis-Pasteur, Schiltigheim, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 Sep;40(5):444-51. doi: 10.1016/j.jgyn.2011.04.001. Epub 2011 May 28.
To report pre- and post-surgical datas of large series of severe twin-to-twin transfusion syndrome (TTTS) managed with laser ablation surgery in our centre, to evaluate the incidence of complications, perinatal outcome and to compare with other cohorts.
Observational study of 100 cases of TTTS consecutively treated with fetoscopic laser coagulation between January 2004 and April 2010 in CMCO-SIHCUS of Schiltigheim.
There are nine stage I, 49 stage II, 38 stage III and four stage 4. Median gestation at time of laser is 20.6 weeks (14-29) whereas median gestation at delivery is 32.6 weeks (16.3-39). Overall perinatal survival rate is 68.5% (137 children over 200). Eighty-five percent have one or more surviving twins. The survival rate is the same for donors and for recipients. Preterm premature rupture of the membranes are observed in 17% of cases and the median gestational age for this complication is 30 weeks (20-34). Cerebral abnormalities are present in 7% of newborns.
Our results for the management of severe TTTS are comparable to the other reported series. There are still many questions remaining concerning the optimal management of TTTS.
报告在我们中心采用激光消融手术治疗的大量严重双胎输血综合征（TTTS）病例的手术前后数据，评估并发症发生率、围产期结局，并与其他队列进行比较。
对2004年1月至2010年4月在施蒂格海姆的CMCO - SIHCUS连续接受胎儿镜激光凝固治疗的100例TTTS病例进行观察性研究。
有9例I期、49例II期、38例III期和4例IV期。激光治疗时的中位孕周为20.6周（14 - 29周），而分娩时的中位孕周为32.6周（16.3 - 39周）。总体围产期存活率为68.5%（200例中有137例存活儿童）。85%的病例有一个或多个存活双胎。供体和受体的存活率相同。17%的病例观察到胎膜早破，该并发症的中位孕周为30周（20 - 34周）。7%的新生儿存在脑异常。
我们对严重TTTS的治疗结果与其他报道的系列相当。关于TTTS的最佳治疗仍有许多问题有待解决。
