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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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1619-3997
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Volume 39, Issue 6

Issues

Neonatal outcome using ultrathin fetoscope for laser coagulation in twin-to-twin-transfusion syndrome

Michael Tchirikov
  • University Clinic of Obstetrics and Fetal Medicine, University Medical Center Halle (Saale) of Martin Luther University of Halle-Wittenberg, Germany
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/ Viktor Oshovskyy
  • University Clinic of Obstetrics and Gynecology, Johannes Gutenberg University of Mainz, Mainz, Germany
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/ Joscha Steetskamp
  • University Clinic of Obstetrics and Gynecology, Johannes Gutenberg University of Mainz, Mainz, Germany
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/ Andreas Falkert / Georgine Huber / Michael Entezami
Published Online: 2011-08-02 | DOI: https://doi.org/10.1515/jpm.2011.091

Abstract

Objective: To improve neonatal outcome using ultrathin fetoscope for laser treatment of twin-to-twin transfusion syndrome.

Methods: Retrospective cohort study of a series of 80 cases of twin-to-twin-transfusion syndrome prior to 26 weeks’ gestation subjected to laser coagulation by means of a 1.0/1.2 mm fiber fetoscope with a sheath sectional area 2.65 mm2/3.34 mm2 (n=27) and a 2.0 mm classic lens fetoscope with a sheath sectional area: 6.63 mm2/11.27 mm2 (n=53).

Results: The survival rates of at least one twin in the compared groups were 94.4% (classic optic) and 100% (ultrathin optic), for both twins: 75.5% and 83.3%, respectively. By decreasing sheath diameter a pregnancy was prolonged by an average of 21.3 days (P=0.0045), with a resulting increase in the recipient’s weight of 389 g (P=0.0049) and an increase in the donor’s Apgar score. However, the intervention with ultrathin optic took 11 min longer (P=0.031).

Conclusion: The reduction of the iatrogenic damage of the amniotic membrane using ultrathin fetoscope with a small sheath, significantly improves the neonatal outcome after laser treatment of twin-to-twin-transfusion syndrome. The operator should only commence working with the 1 mm fetoscope after the learning curve has been accomplished.

Keywords: 1.0 mm Fetoscope; laser coagulation; monochorionic pregnancy; neonatal outcome; twin-to-twin transfusion syndrome

About the article

Corresponding author: Univ.-Prof. Michael Tchirikov, MD, PhD Head of University Clinic of Obstetrics and Fetal Medicine University Medical Center of Martin Luther University Halle-Wittenberg Ernst Grube Straße 40 06120 Halle Germany Tel.: +49-345-5573250 Fax: +49-345-5573251


Received: 2011-04-11

Accepted: 2011-06-06

Published Online: 2011-08-02

Published in Print: 2011-11-01


Citation Information: Journal of Perinatal Medicine, Volume 39, Issue 6, Pages 725–730, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm.2011.091.

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©2011 by Walter de Gruyter Berlin Boston. This content is open access.

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