Laser Saves at Least One Twin in Twin-Twin Transfusion

Survival of one twin independent of Quintero stage after laser photocoagulation of communicator

FRIDAY, May 13 (HealthDay News) -- Use of selective laser photocoagulation of communicating vessels (SLPCV) for patients with twin-twin transfusion syndrome (TTTS) show improved perinatal survival of at least one twin independent of the Quintero stage, according to a study published in the May issue of the American Journal of Obstetrics & Gynecology.

Ramen H. Chmait, M.D., from the University of Southern California in Los Angeles, and colleagues examined Quintero stage-specific perinatal outcomes after SLPCV in 682 women with TTTS. The women underwent SLPCV using sequential and standard laser techniques. The distribution of women according to Quintero staging was 17 percent in stage I, 26 percent in stage II, 48 percent in stage III, and 9 percent in stage IV. Patient characteristics and outcome data were evaluated according to Quintero stage.

The investigators found that the Quintero stage did not affect perinatal survival of at least one twin. Survival of both twins was significantly different in the various stages, (stage I, 79 percent; stage II, 76 percent; stage III, 59 percent; and stage IV, 68 percent). Stage III pregnancies were significantly correlated with decreased donor twin survival. Improved donor survival was seen with sequential SLPCV independent of stage (odds ratio, 1.67).

"In this large multicenter study of TTTS patients treated with uniform laser surgery techniques, we found an overall perinatal survival rate of 91 percent for at least one twin and 67 percent for both twins. Survival for at least one fetus was independent of stage," the authors write.

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