Peeva Gergana, Bower Sarah, Orosz Laszlo, Chaveeva Petya, Akolekar Ranjit, Nicolaides Kypros H
Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.
Fetal Diagn Ther. 2015;38(2):86-93. doi: 10.1159/000374109. Epub 2015 Apr 15.
To determine predictors of survival in monochorionic diamniotic twins with selective fetal growth restriction type II (sFGR-II), with or without twin-to-twin transfusion syndrome (TTTS), treated by endoscopic placental laser coagulation.
Laser surgery was performed at 20 (15-27) weeks' gestation in 405 cases of sFGR-II with and 142 without coexisting TTTS. Multivariable logistic regression analysis was performed to determine significant predictors of survival to discharge from hospital.
There was survival of the small twin in 216 (39.5%) and of the large twin in 379 (69.3%) cases. Significant predictors of survival of both the small and larger twin were ductus venosus Doppler findings in the small twin, gestational age at laser and cervical length, but not the presence of TTTS or Doppler findings in the large twin.
In sFGR-II, survival after laser surgery is primarily dependent on the condition of the small twin.
确定接受内镜下胎盘激光凝固治疗的Ⅱ型选择性胎儿生长受限（sFGR-II）单绒毛膜双羊膜囊双胎（无论有无双胎输血综合征（TTTS））的生存预测因素。
对405例伴有TTTS的sFGR-II病例和142例不伴有TTTS的病例在妊娠20（15 - 27）周时进行激光手术。进行多变量逻辑回归分析以确定出院生存的显著预测因素。
小胎儿存活216例（39.5%），大胎儿存活379例（69.3%）。小胎儿和大胎儿存活的显著预测因素均为小胎儿的静脉导管多普勒检查结果、激光治疗时的孕周和宫颈长度，而非大胎儿是否存在TTTS或多普勒检查结果。
在sFGR-II中，激光手术后的生存主要取决于小胎儿的状况。
