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. 2024;78(3):215-219.
doi: 10.5455/medarh.2024.78.215-219.

Prognostic Factors of Preterm Birth After Selective Laser Umbilical Cord Coagulation for Twin-twin Transfusion Syndrome at Hanoi Obstetrics and Gynecology Hospital

Do Tuan Dat  1   2 , Phan Thi Huyen Thuong  3   4 , Nguyen Thi Thu Ha  3   5 , Nguyen Duy Anh  3   5
Affiliations

Prognostic Factors of Preterm Birth After Selective Laser Umbilical Cord Coagulation for Twin-twin Transfusion Syndrome at Hanoi Obstetrics and Gynecology Hospital

Do Tuan Dat et al. Med Arch. 2024.

Abstract

Background: Twin-Twin Transfusion Syndrome (TTTS) is a serious complication affecting 10-15% of monochorionic diamniotic twin pregnancies, characterized by imbalanced blood flow between fetuses, which can lead to high morbidity and mortality if untreated. Fetoscopic laser photocoagulation has become the standard treatment, offering improved survival rates by interrupting abnormal blood vessel connections.

Objective: This paper focuses on creating models for treatment and diagnosis of patients suffering from Ovaria This study evaluates the prognostic factors influencing the risk of preterm birth after selective laser umbilical cord coagulation in cases of Twin-Twin Transfusion Syndrome (TTTS) stages II-IV.

Methods: A prospective study was conducted from September 2019 to November 2020 at the Fetal Medicine Center of Hanoi Obstetrics and Gynecology Hospital. Twenty-one monochorionic-diamniotic twin pregnancies diagnosed with TTTS underwent selective laser umbilical cord coagulation. Gestational age, cervical length changes, and surgical outcomes were recorded and analyzed.

Results: The mean gestational age at birth was 34.7 ± 4.3 weeks, with an average pregnancy retention of 12.97 weeks post-surgery. Preterm births occurred in 52.6% of cases, with 31.6% before 34 weeks. Surgery performed after 22 weeks of gestation increased the risk of preterm birth by 4.3 times (p = 0.025), while a cervical length reduction of more than 9.5% within 48 hours post-surgery raised the risk by 8.7 times (p = 0.006).

Conclusion: Gestational age at surgery and postoperative cervical length reduction are critical factors influencing the risk of preterm delivery following TTTS treatment.

Keywords: Twin-Twin Transfusion Syndrome; laser; preterm birth; prognostic.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1:
Figure 1:. ROC line shows Two factors predicting premature birth before 34 weeks
See this image and copyright information in PMC

References

    1. Akkermans J, Peeters SH, Middeldorp JM, Klumper FJ, Lopriore E, Ryan G, Oepkes D. A worldwide survey of laser surgery for twin-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2015 Feb;45(2):168–174. doi: 10.1002/uog.14670. Epub 2014 Dec 18. - DOI - PubMed
    1. Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M. Staging of twin-twin transfusion syndrome. J Perinatol. 1999 Dec;19(8 Pt 1):550–555. doi: 10.1038/sj.jp.7200292. - DOI - PubMed
    1. Viral J.S, Pandya M, Colmant C, Ville Y. Current Practice and Protocols: Endoscopic Laser Therapy for Twin-Twin Transfusion Syndrome. Maternal-Fetal Medicine. 2020;2(1):1–9. doi: 10.1097/FM9.0000000000000010. - DOI
    1. Malshe A, Snowise S, Mann LK, Boring N, Johnson A, Bebbington MW, Moise KJ Jr, Papanna R. Preterm delivery after fetoscopic laser surgery for twin-twin transfusion syndrome: etiology and risk factors. Ultrasound Obstet Gynecol. 2017 May;49(5):612–616. doi: 10.1002/uog.15972. - DOI - PubMed
    1. Rahimi-Sharbaf F, Ghaemi M, Nassr AA, Shamshirsaz AA, Shirazi M. Radiofrequency ablation for selective fetal reduction in complicated Monochorionic twins; comparing the outcomes according to the indications. BMC Pregnancy Childbirth. 2021 Mar 6;21(1):189. doi: 10.1186/s12884-021-03656-1. - DOI - PMC - PubMed

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