Dionysopoulou Anna, Stewen Kathrin, Degirmenci Yaman, Schiestl Lina Judit, Hofmann Konstantin, Hasenburg Annette, Schwab Roxana
Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
J Clin Med. 2025 Jun 24;14(13):4476. doi: 10.3390/jcm14134476.
The twin-to twin transfusion syndrome (TTTS) is the most common complication of monochorionic twin pregnancies. Fetal laser therapy (FLT) and serial amniondrainage (SAD) have been used as treatment options for TTTS. This study examines how the management of TTTS in Germany has evolved in the past years and addresses future patient needs and potential challenges for healthcare providers and healthcare systems. The number of TTTS-related interventions between the years 2005 and 2021 were extracted from the German Federal Statistical Office. The trajectory of FLT and SAD procedures over the study period was analyzed. The historical data were used to make projections for future years and address future FLT surgical needs. Further, we aimed to determine age-related influences in monochorionic twin pregnancies requiring FLT. A statistically significant increase in the number of FLT surgeries and a noteworthy decline in the number of SAD procedures with respect to both the number of deliveries per year and the number of multiple pregnancies per year were noted. For the first time, we showed that the percentage of multiple pregnancies requiring FLT was significantly higher in younger mothers under 25 years of age, than in all other age groups. For the moment, FLT poses the only direct and causative treatment of TTTS. The results of our analysis reveal an increasing demand for FLT surgeries for future years. We highlight the need to train more maternal-fetal medicine specialists to be able to perform the procedure safely and to allocate resources efficiently to accommodate the rising number of cases.
双胎输血综合征（TTTS）是单绒毛膜双胎妊娠最常见的并发症。胎儿激光治疗（FLT）和连续羊膜腔引流（SAD）已被用作TTTS的治疗选择。本研究考察了德国过去几年中TTTS的管理是如何演变的，并探讨了未来患者的需求以及医疗服务提供者和医疗系统面临的潜在挑战。2005年至2021年间与TTTS相关的干预措施数量是从德国联邦统计局提取的。分析了研究期间FLT和SAD手术的变化轨迹。利用历史数据对未来几年进行预测，并满足未来FLT手术的需求。此外，我们旨在确定需要FLT的单绒毛膜双胎妊娠中与年龄相关的影响因素。结果发现，就每年的分娩数量和每年的多胎妊娠数量而言，FLT手术数量有统计学意义的增加，而SAD手术数量则显著下降。我们首次表明，25岁以下年轻母亲中需要FLT的多胎妊娠百分比明显高于所有其他年龄组。目前，FLT是TTTS唯一直接的病因治疗方法。我们的分析结果显示未来几年对FLT手术的需求不断增加。我们强调需要培训更多的母胎医学专家，以便能够安全地进行该手术，并有效分配资源以应对不断增加的病例数量。
