Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome

Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome Publisher

Marsoosi V¹ ; Mansouri N² ; Azizi A³ ; Eslamian L¹ ; Jamal A¹ ; Naemi M¹ ; Nurzade M¹ ; Ariana S⁴ ; Sadeghi M⁵

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1. Department of Obstetrics and Gynecology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2. Department of Obstetrics and Gynecology, Imam Reza Hospital Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
3. Social Development and Health Promotion Research Centre, Department of Family & Community Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
4. Department of Obstetrics and Gynecology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5. Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

Source: Biomedical Research and Therapy Published:2024

Abstract

Introduction: Twin-to-twin transfusion syndrome (TTTS) is a critical prenatal complication in monochorionic diamniotic twins with a high risk of mortality and neurological sequelae if left untreated. Of the various therapeutic approaches, fetoscopic laser surgery (FLS) has emerged as the predominant treatment modality worldwide. This study evaluates the outcomes and preoperative risks of TTTS treatment via FLS. Methods: In this prospective cohort study, we analyzed 115 consecutive TTTS cases with gestational ages of 16 to 26 weeks, treated with FLS at Shariati Hospital, Tehran, Iran, from 2018 to 2022. The mean gestational ages at the time of laser surgery and delivery were 20.70 ± 2.21 and 32.18 ± 4.68 weeks, respectively. Postoperative survival was assessed with Doppler measurements post-laser treatment in all but one case, where amniotic sac rupture led to fetal loss. Results: Postoperative survival rates at 30 days were 32.2% for both twins, 53% for either twin, and 85.2% for at least one twin. A notable correlation was observed between donor twin survival and a fetal weight discrepancy exceeding 25%. Additionally, a higher incidence of absent or reversed end-diastolic velocity in the donor umbilical artery was identified among survivors (p < 0.05), indicating a significant survival benefit with FLS. Conclusions: FLS proved to be an effective intervention for TTTS prior to the 26th week of gestation, with outcomes in this Iranian cohort aligning with those reported in developed countries. This underscores FLS's viability as a primary treatment strategy for TTTS, highlighting the importance of early diagnosis and intervention. © Biomedpress.

Style	Citing Format
MLA	Marsoosi V, et al.. "Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome." Biomedical Research and Therapy, vol. 11, no. 2, 2024, pp. 6224-6232.
APA	Marsoosi V, Mansouri N, Azizi A, Eslamian L, Jamal A, Naemi M, Nurzade M, Ariana S, Sadeghi M (2024). Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome. Biomedical Research and Therapy, 11(2), 6224-6232.
Chicago	Marsoosi V, Mansouri N, Azizi A, Eslamian L, Jamal A, Naemi M, Nurzade M, Ariana S, Sadeghi M. "Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome." Biomedical Research and Therapy 11, no. 2 (2024): 6224-6232.
Harvard	Marsoosi V et al. (2024) 'Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome', Biomedical Research and Therapy, 11(2), pp. 6224-6232.
Vancouver	Marsoosi V, Mansouri N, Azizi A, Eslamian L, Jamal A, Naemi M, et al.. Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome. Biomedical Research and Therapy. 2024;11(2):6224-6232.
BibTex	@article{ author = {Marsoosi V and Mansouri N and Azizi A and Eslamian L and Jamal A and Naemi M and Nurzade M and Ariana S and Sadeghi M}, title = {Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome}, journal = {Biomedical Research and Therapy}, volume = {11}, number = {2}, pages = {6224-6232}, year = {2024} }
RIS	TY - JOUR AU - Marsoosi V AU - Mansouri N AU - Azizi A AU - Eslamian L AU - Jamal A AU - Naemi M AU - Nurzade M AU - Ariana S AU - Sadeghi M TI - Evaluation of the Success of Fetoscopic Laser Coagulation in Placental Vascular Anastomoses and the Role of Fetal Vascular Doppler Before Laser Treatment in Twin-To-Twin Transfusion Syndrome JO - Biomedical Research and Therapy VL - 11 IS - 2 SP - 6224 EP - 6232 PY - 2024 ER -

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