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Am J Obstet Gynecol. 2009 Jul;201(1):66.e1-4. doi: 10.1016/j.ajog.2009.01.010.

Residual anastomoses in twin-to-twin transfusion syndrome treated with selective fetoscopic laser surgery: localization, size, and consequences.

Author information

1
Department of Pediatrics, Division of Neonatology, Leiden University Medical Centre, Leiden, The Netherlands.

Abstract

OBJECTIVE:

To study the localization and size of residual anastomoses in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery and correlate the findings with outcome.

STUDY DESIGN:

Placental injection in twin-to-twin transfusion syndrome placentas treated with laser was performed by using colored dye.

RESULTS:

A total of 77 twin-to-twin transfusion syndrome placentas were included in the study. Residual anastomoses (n = 48) were found in 32% (25/77) of lasered placentas. Most residual anastomoses were localized near the margin of the placenta. The majority of residual anastomoses (67%; 32/48) were very small (diameter, < 1 mm). Eleven of the 25 cases (44%) in the residual anastomoses group developed twin anemia-polycythemia sequence.

CONCLUSION:

Most residual anastomoses in twin-to-twin transfusion syndrome placentas treated with laser are very small and localized near the placental margin. Almost half of cases with residual anastomoses developed twin anemia-polycythemia sequence after laser surgery.

PMID:
19306965
DOI:
10.1016/j.ajog.2009.01.010
[Indexed for MEDLINE]

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