Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, France.
Department of Obstetrics and Fetal Therapy, AP-HP, Necker-Enfants Malades Hospital, Paris, France.
Prenat Diagn. 2018 Mar;38(4):293-297. doi: 10.1002/pd.5227. Epub 2018 Feb 19.
The objective of our study was to determine the impact of laser therapy for twin-to-twin transfusion syndrome (TTTs) on subsequent pregnancies.
This was a monocentric retrospective observational study. Women treated by laser fetoscopy for TTTs were asked to answer a postal questionnaire about subsequent pregnancies. The primary outcome was fecundity (number of pregnancies and time to pregnancy). We also assessed pregnancy complications, birth weight, and gestational age at delivery. Pregnancy complications included the following: threatened preterm labor, preeclampsia, placenta accreta, postpartum hemorrhage, and psychological disorders. Our study population was compared with an external control group made up of mothers of monochorionic twins without TTTs.
We included 122 cases managed at the Necker Hospital between 2008 and 2012 and 39 controls. The median conception time was longer in the TTTs group (6.4 ± 11.1 versus 2 ± 1.6 months, P = .03). The numbers of live childbirths at the end of those pregnancies were equivalent (77.6% versus 66.7%, P = .56). Birth weight (3317 ± 726 versus 3240 ± 382 g, P = .81) and gestational age at delivery (38.2 ± 6.8 WG versus 39.5 ± 1.2 WG, P = .64) were similar, with no increase of obstetrical complications compared with the control group.
Twin-to-twin transfusion syndrome and its treatment do not seem to impact subsequent pregnancies.
本研究旨在确定激光治疗双胎输血综合征（TTTs）对后续妊娠的影响。
这是一项单中心回顾性观察性研究。我们通过邮寄问卷的方式，对在我院接受激光胎儿镜治疗 TTTs 的女性进行随访，了解其后续妊娠情况。主要结局为生育能力（妊娠次数和妊娠时间）。我们还评估了妊娠并发症、出生体重和分娩时的孕周。妊娠并发症包括早产先兆、子痫前期、胎盘植入、产后出血和心理障碍。我们的研究人群与一组无 TTTs 的单绒毛膜双胞胎的母亲组成的外部对照组进行了比较。
我们纳入了 2008 年至 2012 年在 Necker 医院接受治疗的 122 例病例和 39 例对照。TTTs 组的受孕中位时间较长（6.4±11.1 个月比 2±1.6 个月，P=0.03）。这些妊娠的活产数相当（77.6%比 66.7%，P=0.56）。出生体重（3317±726 克比 3240±382 克，P=0.81）和分娩时的孕周（38.2±6.8 周比 39.5±1.2 周，P=0.64）相似，与对照组相比，产科并发症没有增加。
双胎输血综合征及其治疗似乎不会影响后续妊娠。
