Journal article
Neonatal Outcomes and Maternal Characteristics in Monochorionic Diamniotic Twin Pregnancies: Uncomplicated versus Twin-to-Twin Transfusion Syndrome Survivors after Fetoscopic Laser Surgery
Fetal diagnosis and therapy, v 47(2), pp 165-170
01 Feb 2020
PMID: 31434071
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Preterm birth remains a major complication of fetal laser surgery (FLS) due to twin-to-twin transfusion syndrome (TTTS). Objectives: We tested the hypothesis that neonatal outcomes in fetuses born at >24 weeks are worse in TTTS survivors compared to uncomplicated monochorionic diamniotic (MCDA) twins. Methods: 196 patients with TTTS treated with laser therapy and 91 uncomplicated MCDA gestations were compared. Neonatal outcomes included respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death. Risk factors assessed were TTTS, maternal age, maternal body mass index, race, premature prolonged rupture of membranes, stage of TTTS, parity, and gestational age (GA) at delivery. Results: GA at delivery was lower in the TTTS group (31.0 +/- 4.6 vs. 33.5 +/- 2.4 weeks, p < 0.001). RDS and TTN occurred at higher rates in the TTTS than in the uncomplicated MCDA group. After multivariate logistic regression, the only factor significantly associated with the composite adverse outcome was GA at delivery (OR 0.61; 95% CI: 0.58-0.7). Conclusion: TTTS twins treated with FLS are deliver 2.5 weeks earlier than uncomplicated MCDA twins. Respiratory complications were significantly higher in TTTS twins and were mainly the consequence of the early GA at delivery.
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Details
- Title
- Neonatal Outcomes and Maternal Characteristics in Monochorionic Diamniotic Twin Pregnancies: Uncomplicated versus Twin-to-Twin Transfusion Syndrome Survivors after Fetoscopic Laser Surgery
- Creators
- Ciprian P. Gheorghe - Memorial HermannNoemi Boring - Memorial HermannLovepreet Mann - Memorial HermannRoopali Donepudi - Memorial HermannSuzanne M. Lopez - The University of Texas Health Science CenterSuneet P. Chauhan - The University of Texas Health Science CenterVineet Bhandari - Drexel UniversityKenneth J. Moise - Memorial HermannAnthony Johnson - Memorial HermannRamesha Papanna - Memorial Hermann
- Publication Details
- Fetal diagnosis and therapy, v 47(2), pp 165-170
- Publisher
- Karger
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000512611400010
- Scopus ID
- 2-s2.0-85075082970
- Other Identifier
- 991019167470104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology