TY - JOUR
T1 - Dual demise following laser surgery for twin-twin transfusion syndrome
T2 - Analysis of 52 cases at a single fetal surgery center
AU - Youssefzadeh, Ariane C.
AU - Glassen, Gabrielle L.
AU - Chon, Andrew H.
AU - Korst, Lisa M.
AU - Esakoff, Tania F.
AU - Afshar, Yalda
AU - Gheorghe, Ciprian P.
AU - Llanes, Arlyn
AU - Chmait, Ramen H.
N1 - Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2021/11
Y1 - 2021/11
N2 - Objective: To evaluate all individual cases of dual twin demise following laser surgery for twin-twin transfusion syndrome (TTTS). Method: This is an analysis of all monochorionic diamniotic twin gestations with TTTS complicated by dual demise following laser surgery from 2006 to 2019. Cases were reviewed by (1) a fetal surgeon researcher and (2) a panel of independent experienced maternal-fetal medicine specialists to code an etiology of demise for the donor and recipient, and to assess for possible preventability. Results: Of 753 twins that underwent laser surgery for TTTS, 52 (6.9%) had postoperative dual demise. In this subgroup, gestational age at surgery was 19.5 (16.1–24.9) weeks, and 36 (69.2%) patients were Quintero stage III and IV. The most common etiology was the spectrum of disorders leading to preterm delivery, which included cervical insufficiency, preterm premature rupture of membranes, and preterm labor (44.2% and 48.1%, donor and recipient, respectively). Some degree of preventability was estimated for 23.1% of dual demises. Conclusions: The most common cause of dual demise post laser surgery for TTTS was preterm birth, reinforcing the need for studies regarding the etiology and prevention of post-fetoscopy prematurity. Nearly one-quarter of dual demise cases were deemed potentially preventable.
AB - Objective: To evaluate all individual cases of dual twin demise following laser surgery for twin-twin transfusion syndrome (TTTS). Method: This is an analysis of all monochorionic diamniotic twin gestations with TTTS complicated by dual demise following laser surgery from 2006 to 2019. Cases were reviewed by (1) a fetal surgeon researcher and (2) a panel of independent experienced maternal-fetal medicine specialists to code an etiology of demise for the donor and recipient, and to assess for possible preventability. Results: Of 753 twins that underwent laser surgery for TTTS, 52 (6.9%) had postoperative dual demise. In this subgroup, gestational age at surgery was 19.5 (16.1–24.9) weeks, and 36 (69.2%) patients were Quintero stage III and IV. The most common etiology was the spectrum of disorders leading to preterm delivery, which included cervical insufficiency, preterm premature rupture of membranes, and preterm labor (44.2% and 48.1%, donor and recipient, respectively). Some degree of preventability was estimated for 23.1% of dual demises. Conclusions: The most common cause of dual demise post laser surgery for TTTS was preterm birth, reinforcing the need for studies regarding the etiology and prevention of post-fetoscopy prematurity. Nearly one-quarter of dual demise cases were deemed potentially preventable.
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U2 - 10.1002/pd.6058
DO - 10.1002/pd.6058
M3 - Article
C2 - 34669208
AN - SCOPUS:85117595059
SN - 0197-3851
VL - 41
SP - 1548
EP - 1559
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 12
ER -