Tchirikov, Michael and Zuehlke, Anja and Schlabritz-Lutsevich, Natalia and Entezami, Michael and Seliger, Gregor and Bergner, Michael and Li, Weijing and Koeninger, Angela and Wienke, Andreas and Yusupbaev, Rustem and Ebert, Andreas D. (2024) Fetoscopic laser coagulation for twin-to-twin transfusion syndrome: a comparison of flexible 1.0/1.2 mm fetoscopes with curved sheaths of 2.7/3.3 mm<SUP>2</SUP> vs. 2 mm fetoscopic lens technique with sheaths of 6.6/11.3 mm<SUP>2</SUP>. JOURNAL OF PERINATAL MEDICINE, 52 (5). pp. 530-537. ISSN 0300-5577, 1619-3997
Full text not available from this repository. (Request a copy)Abstract
Objectives Fetoscopic laser coagulation of placental anastomoses is usually performed for a treatment of twin-to-twin transfusion syndrome (TTTS). A common complication of fetoscopic laser coagulation for TTTS is preterm preliminary rupture of fetal membranes (PPROM) aggravating the neonatal outcome significantly. However, use of an flexible 1 mm fetoscope with an curved sheath could reduce iatrogenic damage of the amniotic membrane and improve neonatal outcomes after laser treatment. The aim of this study was to compare neonatal outcomes using this flexible fetoscope with curved sheath vs. use of a standard lens technique. Methods Outcomes were retrospective analyzed after use of a standard lens fetoscope of 2 mm (sheath 6.63 mm2 or 11.27 mm(2) for anterior placenta) and a flexible fetoscope of 1 mm or 1.2 mm (sheath 2.65 mm(2) or 3.34 mm(2)) in two German centers of fetal surgery, performed during 2006-2019. Results Neonatal outcome of 247 TTTS patients were analyzed including the rates of double and single fetal survival. The survival of at least one fetus was 97.2 % in the group with the ultrathin technique (n=154) compared to 88.3 % (n=93) in the group with the standard lens fetoscope (p=0.008). Survival of both fetuses was not different between groups (81.0 vs. 75.3 %). The procedure to delivery interval was significantly increased using the ultrathin fetoscope (89.1 +/- 35.0 d vs. 71.4 +/- 35.4 d, p=0.001) resulting in an increased gestational age at delivery by 11 days on average (231.9 +/- 28.1 d vs. 221.1 +/- 32.7 d, p=0.012). Conclusions Fetal survival can be significantly increased following TTTS using flexible fetoscope of 1 mm or 1.2 mm (sheath 2.65 mm(2) or 3.34 mm(2))
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PLACENTAL ANASTOMOSES; RISK-FACTORS; SURGERY; FETAL; PREGNANCIES; ABLATION; PHOTOCOAGULATION; COMPLICATIONS; MANAGEMENT; THERAPY; laser treatment; neonatal outcome; twin-twin transfusion syndrome; twin-to-twin transfusion syndrome (TTTS); 1 mm fetoscope; intrauterine surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Geburtshilfe) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Jan 2026 07:52 |
| Last Modified: | 16 Jan 2026 07:52 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65484 |
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