Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Am J Obstet Gynecol. 2013 Mar;208(3):197.e1-7. doi: 10.1016/j.ajog.2012.11.027. Epub 2012 Nov 21.
The purpose of this study was to compare perinatal outcomes of pregnancies that undergo "early" (<17 weeks' gestation) or "late" (>26 weeks' gestation) fetoscopic laser ablation of placental vascular anastomoses for twin-twin transfusion syndrome (TTTS) with "conventional" cases that were treated at 17-26 weeks' gestation.
We conducted a single center, retrospective analysis of 325 consecutive pregnancies that underwent fetoscopic laser therapy for severe TTTS.
Twenty-four "early," 18 "late," and 283 "conventional" pregnancies with severe TTTS underwent laser therapy. Fetoscopy duration, gestation at delivery, survival rate, and complications were comparable among groups, except for preterm premature rupture of membranes at <7 days after laser therapy, which was more common in the "early" group than in either of the other 2 groups.
Laser therapy for TTTS at <17 or >26 weeks' gestation has similar outcomes to procedures done at 17-26 weeks' gestation. We suggest that conventional gestational age guidelines of 16-26 weeks for laser therapy for TTTS should be reevaluated.
本研究旨在比较胎儿镜下胎盘吻合血管激光消融术治疗双胎输血综合征（TTTS）中“早期”（<17 孕周）或“晚期”（>26 孕周）妊娠与“常规”（17-26 孕周）病例的围产期结局。
我们对 325 例连续接受胎儿镜激光治疗的严重 TTTS 妊娠进行了单中心回顾性分析。
24 例“早期”、18 例“晚期”和 283 例“常规”严重 TTTS 妊娠接受了激光治疗。除了激光治疗后<7 天的早产胎膜早破发生率较高外，各组之间的胎儿镜检查持续时间、分娩时孕周、存活率和并发症发生率相似。
17 周前或 26 周后 TTTS 的激光治疗与 17-26 周的治疗效果相似。我们建议应重新评估 TTTS 激光治疗的 16-26 周常规妊娠年龄指南。
