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. 2010 Mar;30(3):188-91.
doi: 10.1038/jp.2009.151. Epub 2009 Oct 1.

Fetal heart rate changes associated with sequential selective laser surgery for twin-twin transfusion syndrome

S A Assaf  1 , A Khan, L M Korst, R H Chmait
Affiliations

Fetal heart rate changes associated with sequential selective laser surgery for twin-twin transfusion syndrome

S A Assaf et al. J Perinatol. 2010 Mar.

Abstract

Objective: To investigate perioperative changes in fetal heart rate (FHR) associated with sequential vs standard selective laser photocoagulation of communicating vessels for the treatment of twin-twin transfusion syndrome (TTTS).

Study design: Women with TTTS were treated with the intent of using the sequential procedure. Those who failed this treatment were categorized as having undergone the standard procedure. Pre- and postoperative FHR of donor and recipient fetuses were analyzed.

Result: Of 98 women, 35 received the standard technique. A postoperative drop in the mean donor FHR was observed in gestations receiving the standard laser, but not in those receiving the sequential technique. In multivariable models that included operative and gestational characteristics, the use of the sequential treatment was associated with improved stability of the FHR of the donor twin.

Conclusion: The stability in donor FHR following sequential laser ablation when compared with the standard technique is consistent with improved donor hemodynamics.

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References

    1. Quintero R, Quintero L, Bornick P, Allen M, Johnson P. The donor-recipient (D-R) score: in vivo endoscopic evidence to support the hypothesis of a net transfer of blood from donor to recipient in twin-twin transfusion syndrome. Prenat Neonat Med. 2000;5:84–91.
    1. Quintero R, Morales W, Mendoza G, Allen M, Kalter C, Giannina G, et al. Selective photocoagulation of placental vessels in twin-twin transfusion syndrome: evolution of a surgical technique. Obstet Gynecol Surv. 1998;53:s97–s103. - PubMed
    1. Quintero RA, Ishii K, Chmait RH, Bornick PW, Allen MH, Kontopoulos EV. Sequential selective laser photocoagulation of communicating vessels in twin-twin transfusion syndrome. J Matern Fetal Neonatal Med. 2007;20 10:763–768. - PubMed
    1. Van Gemert MJC, van den Wijngaard JPHM, Lopriore BE, Lewid L, Deprest J, Vandenbussche FPH. Simulated sequential laser therapy of twin-twin transfusion syndrome. Placenta. 2008;29 7:609–613. - PubMed
    1. MacDonald AA, Rose J, Heymann MA, Rudoolph AM. Heart rate response of fetal and adult sheep to hemorrhage stress. Am J Physiol. 1980;239:H789–H793. - PubMed