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. 2022 Sep 29:9:942816.
doi: 10.3389/fmed.2022.942816. eCollection 2022.

Effect of fetoscopic laser surgery on the placental characteristics and birth-weight discordance of twins with twin-to-twin transfusion syndrome

Xueju Wang  1 , Luyao Li  1 , Pengbo Yuan  1 , Yangyu Zhao  1 , Yuan Wei  1
Affiliations

Effect of fetoscopic laser surgery on the placental characteristics and birth-weight discordance of twins with twin-to-twin transfusion syndrome

Xueju Wang et al. Front Med (Lausanne). .

Abstract

Objective: This study explored the effect of fetoscopic laser surgery on the placental structure and birth-weight discordance of twin-to-twin transfusion syndrome (TTTS).

Methods: 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.

Results: 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, p < 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%, p < 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, p = 0.001). In the laser group, the birth-weight discordance ratio was positively correlated with the placental territory discordance ratio (Spearman coefficient = 0.556; p = 0.001).

Conclusion: The birth-weight discordance is positively correlated with placental territory discordance in TTTS patients after FLS.

Keywords: anastomoses; birth-weight; fetoscopic laser surgery; placental territory; twin-to-twin transfusion syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
An image of the placenta after dye injection (A) placenta without laser surgery, red arrow, artery-artery anastomosis, black arrow, artery-vein anastomosis, blue curve, placental separate line; (B) placental with laser surgery, orange arrow, laser coagulation line.
FIGURE 2
FIGURE 2
Flowcharts depicting the patient inclusion criteria.
See this image and copyright information in PMC

References

    1. Kontopoulos E, Chmait RH, Quintero RA. Twin-to-twin transfusion syndrome: definition, staging, and ultrasound assessment. Twin Res Hum Genet. (2016) 19:175–83. 10.1017/thg.2016.34 - DOI - PubMed
    1. Benoit RM, Baschat AA. Twin-to-twin transfusion syndrome: prenatal diagnosis and treatment. Am J Perinatol. (2014) 31:583–94. 10.1055/s-0034-1372428 - DOI - PubMed
    1. Shanahan MA, Bebbington MW. Placental anatomy and function in twin gestations. Obstet Gynecol Clin North Am. (2020) 47:99–116. 10.1016/j.ogc.2019.10.010 - DOI - PubMed
    1. Glennon CL, Shemer SA, Palma-Dias R, Umstad MP. The history of treatment of twin-to-twin transfusion syndrome. Twin Res Hum Genet. (2016) 19:168–74. - PubMed
    1. Kalafat E, Thilaganathan B, Papageorghiou A, Bhide A, Khalil A. Significance of placental cord insertion site in twin pregnancy. Ultrasound Obstet Gynecol. (2018) 52:378–84. 10.1002/uog.18914 - DOI - PubMed