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Fetoscopic laser photocoagulation in the management of twin-twin transfusion syndrome: local experience from Hong Kong Yang X; Leung TY; Ngan Kee WD; Chen M; Chan LW; Lau TKHong Kong Med J 2010[Aug]; 16 (4): 275-81OBJECTIVE: To review the perinatal outcome of monochorionic twin pregnancies treated by fetoscopic laser coagulation for twin-twin transfusion syndrome. DESIGN: Retrospective study. SETTING: A university teaching hospital in Hong Kong. PATIENTS: Thirty consecutive cases of fetoscopic laser coagulation of placental anastomoses for twin-twin transfusion syndrome performed in a single centre. MAIN OUTCOME MEASURES: Operative complications and perinatal survival rates. RESULTS: The median gestational age at initial presentation, laser photocoagulation, and delivery were 22 (range, 16-27) weeks, 23 (18-28) weeks, and 32 (21-37) weeks, respectively. To improve the visualisation, in three cases amnio-exchange was undertaken; the procedure was abandoned in two due to poor visualisation. The overall fetal survival rate, the double infant survival rate, and survival rate for at least one twin were 72% (43/60), 60% (18/30), and 83% (25/30), respectively. The most common peri-operative complication was bleeding from the uterine wall into the amniotic cavity, which affected three (10%) patients. CONCLUSIONS: Our results of fetoscopic laser surgery for twin-twin transfusion syndrome were similar to those in specialised centres in other countries.|Female[MESH]|Fetofetal Transfusion/*surgery[MESH]|Fetoscopy/adverse effects/*methods[MESH]|Gestational Age[MESH]|Hong Kong[MESH]|Hospitals, University[MESH]|Humans[MESH]|Infant, Newborn[MESH]|Laser Coagulation/adverse effects/*methods[MESH]|Postoperative Complications[MESH]|Pregnancy[MESH]|Pregnancy Outcome[MESH]|Retrospective Studies[MESH]|Survival Rate[MESH]|Twins, Monozygotic[MESH]|Uterine Hemorrhage/etiology[MESH] |
