Wang Xueju, Li Luyao, Yuan Pengbo, Zhao Yangyu, Wei Yuan
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Front Med (Lausanne). 2022 Sep 29;9:942816. doi: 10.3389/fmed.2022.942816. eCollection 2022.
This study explored the effect of fetoscopic laser surgery on the placental structure and birth-weight discordance of twin-to-twin transfusion syndrome (TTTS).
A retrospective cohort study was conducted in TTTS patients who were admitted to the Peking University Third Hospital between April 2014 and April 2020. The patients were divided into two groups: laser group and control group. Placentas with twin survival were injected, and pregnancy outcomes and placental characteristics of the two groups were compared. The correlation between the birth-weight discordance and placental characteristics in each group was analyzed.
The gestational age at first diagnosis in the laser group was significantly smaller than that in the control group (21.6 ± 2.8 weeks vs. 27.7 ± 3.0 weeks, < 0.001). The proportion of patients with TTTS stage-I in the laser group was significantly lower than the control group (9.4 vs. 64.0%, < 0.001). The gestational age at delivery in the laser group was significantly larger than that in the control group (33.6 ± 2.1 weeks vs. 31.4 ± 2.5 weeks, = 0.001). In the laser group, the birth-weight discordance ratio was positively correlated with the placental territory discordance ratio (Spearman coefficient = 0.556; = 0.001).
The birth-weight discordance is positively correlated with placental territory discordance in TTTS patients after FLS.
本研究探讨胎儿镜激光手术对双胎输血综合征（TTTS）胎盘结构及出生体重不一致的影响。
对2014年4月至2020年4月在北京大学第三医院住院的TTTS患者进行回顾性队列研究。将患者分为两组：激光组和对照组。对双胎存活的胎盘进行注射，并比较两组的妊娠结局和胎盘特征。分析每组出生体重不一致与胎盘特征之间的相关性。
激光组首次诊断时的孕周显著小于对照组（21.6±2.8周 vs. 27.7±3.0周，<0.001）。激光组TTTS I期患者比例显著低于对照组（9.4% vs. 64.0%，<0.001）。激光组分娩时的孕周显著大于对照组（33.6±2.1周 vs. 31.4±2.5周，=0.001）。在激光组中，出生体重不一致率与胎盘面积不一致率呈正相关（Spearman系数 = 0.556；=0.001）。
FLS术后TTTS患者的出生体重不一致与胎盘面积不一致呈正相关。
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