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twin to twin transfusion syndrome laser

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https://www.readbyqxmd.com/read/28434005/chorioamniotic-membrane-separation-after-fetoscopic-laser-photocoagulation
#1
Mayumi Takano, Masahiko Nakata, Susumu Murata, Masahiro Sumie, Mineto Morita
INTRODUCTION: This study aimed to investigate the risk factors, incidence, and influence on the perinatal outcome of chorioamniotic membrane separation (CMS) after fetoscopic laser photocoagulation (FLP). MATERIAL AND METHODS: This retrospective study included 312 women who underwent FLP for twin-to-twin transfusion syndrome (TTTS). Clinical records were used to review obstetrical examinations, complications, operative data, ultrasonographic findings, and perinatal and neonatal follow-up data in all patients...
April 22, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28403975/-fetoscopic-laser-coagulation-in-200%C3%A2-consecutive-monochorionic-pregnancies-with-twin-twin-transfusion-syndrome
#2
L Lecointre, N Sananès, A S Weingertner, A Gaudineau, C Akladios, V Cavillon, B Langer, R Favre
OBJECTIVES: To report preoperative data, surgical characteristics, complications and perinatal outcome of twin-twin transfusion syndrome (TTTS) managed with laser ablation surgery, to analyze predictors of neonatal survival and to compare the 100 most recent cases with the older 100. MATERIALS AND METHODS: Observational cohort moncentric study of 200 cases of TTTS consecutively treated with fetoscopic laser coagulation between January 2004 and December 2014...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28370497/cardiac-pathophysiology-in-twin-twin-transfusion-syndrome-new-insights-into-its-evolution
#3
Christoph Wohlmuth, David Boudreaux, Kenneth J Moise, Anthony Johnson, Ramesha Papanna, Michael Bebbington, Helena M Gardiner
OBJECTIVES: In twin-twin transfusion syndrome (TTTS) unbalanced transfer of vasoactive mediators and fluid from the 'donor' to the 'recipient' alters cardiovascular function. We evaluated cardiac function in 145 monochorionic-diamniotic (MCDA) pregnancies with and without TTTS. METHODS: Echocardiography was performed in uncomplicated MCDA, n = 26; TTTS stage I+II, n = 61; TTTS stage III+IV, n = 58, before selective fetoscopic laser photocoagulation (SFLP) in TTTS, and afterwards in 41 (34%) at a mean of 1...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28370096/recipient-twin-circular-shunt-physiology-before-fetal-laser-surgery-survival-and-risks-for-postnatal-right-ventricular-outflow-tract-obstruction
#4
Jay D Pruetz, Jodie K Votava-Smith, Hikmat R Chmait, Lisa M Korst, Arlyn Llanes, Ramen H Chmait
OBJECTIVES: To evaluate risk for congenital heart disease (CHD) in recipient twins with circular shunt physiology (CSP). METHODS: This prospective study enrolled twin-twin transfusion syndrome (TTTS) cases from 2006 to 2015. Fetal echocardiography (FE) was performed before laser surgery when cardiac involvement was suspected. Diagnosis of recipient twin CSP required tricuspid and pulmonary regurgitation, right ventricular dysfunction, and flow reversal in the ductus arteriosus...
April 3, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28351037/impact-of-laser-power-and-firing-angle-on-coagulation-efficiency-in-laser-treatment-for-twin-twin-transfusion-syndrome-an-ex-vivo-placenta-study
#5
Joost Akkermans, Loes van der Donk, Suzanne H P Peeters, Sjoerd van Tuijl, Johanna M Middeldorp, Enrico Lopriore, Dick Oepkes
OBJECTIVE: To assess the impact of laser power and firing angle on coagulation efficiency for closing placental anastomoses in the treatment of twin-twin transfusion syndrome. METHODS: We used an ex vivo blood-perfused human placenta model to compare time to complete coagulation using 30 vs. 50 W of neodymium-doped yttrium aluminum garnet laser power and using a firing angle of 90° vs. 45°. Placentas were perfused with pig blood at 5 mL/min. Differences were analyzed using independent-samples t test, Mann-Whitney U test, or χ2 test as appropriate...
March 29, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28335669/the-experience-of-modified-sequential-selective-laser-photocoagulation-of-communicating-vessels-technique-for-twin-twin-transfusion-syndrome
#6
Susumu Murata, Mayumi Takano, Yukiko Kagawa, Masahiro Sumie, Masahiko Nakata
OBJECTIVE: Fetoscopic laser photocoagulation of vascular anastomoses is the essential choice in twin-twin transfusion syndrome (TTTS). We proposed that the modified sequential selective laser photocoagulation of communicating vessels (modified SQLPCV) to clarify the perinatal outcomes in TTTS. METHODS: The modified SQLPCV was designed with the following order: 1, artery-to-artery anastomoses; 2, venous-to-venous anastomoses; 3, artery-to-venous anastomoses from donor to recipient; and 4, artery-to-venous anastomoses from recipient to donor...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28320252/the-impact-of-laser-surgery-on-angiogenic-and-anti-angiogenic-factors-in-twin-twin-transfusion-syndrome-a-prospective-study
#7
Andrew H Chon, Emiliano R Chavira, Melissa L Wilson, Sue A Ingles, Arlyn Llanes, Ramen H Chmait
OBJECTIVE: To examine the effect of laser surgery on angiogenic and anti-angiogenic factors in patients with twin-twin transfusion syndrome (TTTS). METHODS: Cases of TTTS and uncomplicated monochorionic diamniotic twin pregnancies between 16-26 weeks' gestation were prospectively enrolled into the study. Maternal blood samples were obtained to measure angiogenic factors (vascular endothelial growth factor-A (VEGF), placental-derived growth factor (PlGF), endothelin) and anti-angiogenic factors (soluble fms-like tyrosine kinase (sFlt-1), soluble endoglin (sEng), sFlt-1/PlGF ratio)...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28287588/medical-grade-sterilizable-target-for-fluid-immersed-fetoscope-optical-distortion-calibration
#8
Daniil I Nikitichev, Dzhoshkun I Shakir, François Chadebecq, Marcel Tella, Jan Deprest, Danail Stoyanov, Sébastien Ourselin, Tom Vercauteren
We have developed a calibration target for use with fluid-immersed endoscopes within the context of the GIFT-Surg (Guided Instrumentation for Fetal Therapy and Surgery) project. One of the aims of this project is to engineer novel, real-time image processing methods for intra-operative use in the treatment of congenital birth defects, such as spina bifida and the twin-to-twin transfusion syndrome. The developed target allows for the sterility-preserving optical distortion calibration of endoscopes within a few minutes...
February 23, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28285310/incidence-and-causes-of-intentional-fetal-or-neonatal-demise-in-twin-twin-transfusion-syndrome
#9
Marjolijn S Spruijt, Ellen Tameeris, De-Peng Zhao, Johanna M Middeldorp, Monique C Haak, Dick Oepkes, Enrico Lopriore
INTRODUCTION: The aim of this study is to evaluate the incidence and causes of intentional fetal and neonatal demise in twin-twin transfusion syndrome (TTTS). MATERIAL AND METHODS: All TTTS pregnancies managed at our centre between 2000 and 2014 were included. We evaluated incidence and causes of intentional fetal/neonatal demise, defined as termination of pregnancy, selective fetal reduction, or withdrawal of neonatal intensive care. RESULTS: Intentional fetal/neonatal demise occurred in 9...
March 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28281301/doppler-assessment-of-patients-with-twin-to-twin-transfusion-syndrome-and-survival-following-fetoscopic-laser-surgery
#10
Enrique Gil Guevara, Andrea Pazos, Otilia Gonzalez, Pilar Carretero, Francisca S Molina
OBJECTIVE: To investigate fetal-survival rates following laser surgery for twin-to-twin transfusion syndrome (TTTS) and the impact of Doppler analysis. METHODS: The present retrospective single-center study included data from patients with pregnancies exhibiting TTTS treated with fetoscopic laser surgery between January 1, 2007, and December 31, 2016. Perinatal outcomes were examined and variables were compared between the donor and recipient fetuses that survived and died, respectively...
March 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28114847/virtual-three-dimensional-placentoscopy-a-new-approach-to-assess-residual-anastomoses-following-laser-photocoagulation-in-twin-to-twin-transfusion-syndrome
#11
Roberto Noya Galluzo, Mario Júlio Franco, Leila Wessler Faust, Karine Souza Dacorégio, Jair Roberto da Silva Braga, Heron Werner Junior, Edward Araujo Júnior
Twin-to-twin transfusion syndrome (TTTS) complicates 10% of monochorionic twin pregnancies and it is consequence of an unbalanced exchange blood through the vascular anastomoses at placental surface. If not treated, mortality rates in TTTS may be as high as 80-100%. Laser photocoagulation of the placental anastomoses is the first treatment option; however, in some situations, the damage of the placenta in the postpartum may become difficult the residual anastomoses identification. We propose a new non-invasive technique to assess the residual anastomoses using computed tomography (CT) scan data to generate a three-dimensional (3D) virtual placentoscopy...
February 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28008591/mirror-syndrome-after-fetoscopic-laser-treatment-a-case-report
#12
Ana Maria Simões Brandão, Ana Patrícia Rodrigues Domingues, Etelvina Morais Ferreira Fonseca, Teresa Maria Antunes Miranda, José Paulo Achando Silva Moura
Mirror syndrome is a rare disease with unknown pathophysiology that can be present in different diseases that can cause fetal hydrops. The prognosis is usually bad with a high perinatal mortality. We report an unusual form of mirror syndrome that manifested itself only after a successful treatment for fetal hydrops (caused by twin-twin transfusion syndrome, in Quinteros stage IV) was performed. This syndrome was controlled by medical treatment, and despite the usually bad prognosis seen in these cases, we could extend the pregnancy from the 23rd to the 34th week of gestation, resulting in the birth of 2 live infants...
November 2016: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28003695/anaesthesia-for-foetoscopic-laser-ablation-a-retrospective-study
#13
Vaishali Kumbhar, M Radhika, Parameswara Gundappa, Jayashree Simha, Prathima Radhakrishnan
BACKGROUND AND AIMS: Twin pregnancy with monochorionic placenta may be associated with arteriovenous vascular anastomosis of the placental vessels resulting in twin-to-twin transfusion syndrome (TTTS) and twin reversed arterial perfusion syndrome (TRAP). Foetoscopic LASER ablation (FLA) is the treatment of choice in reducing foetal mortality related to this. METHODS: A retrospective review of medical records of 41 FLA procedures for TTTS and TRAP were analysed for anaesthetic management...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27813120/prediction-of-neonatal-outcome-of-ttts-by-fetal-heart-and-doppler-ultrasound-parameters-before-and-after-laser-treatment
#14
A Delabaere, F Leduc, Q Reboul, F Fuchs, S Wavrant, J C Fouron, F Audibert
OBJECTIVES: To determine the prognostic value of fetal Doppler and echocardiographic parameters for neonatal survival up to 30 days after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS). METHODS: Fetal echocardiography and outcome data of consecutive cases of TTTS treated by laser were retrospectively reviewed. Hemodynamic and cardiac function parameters were collected before and after laser. RESULTS: Between February 2006 and January 2015, 106 fetoscopic laser were performed...
December 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27764900/evaluation-of-long-term-neurodevelopment-in-twin-twin-transfusion-syndrome-after-laser-therapy
#15
Nicolas Sananès, Victor Gabriele, Anne Sophie Weingertner, Rodrigo Ruano, Magdalena Sanz-Cortes, Adrien Gaudineau, Bruno Langer, Israël Nisand, Chérif Youssef Akladios, Romain Favre
OBJECTIVE: The primary objective of our study was to evaluate the long-term neurodevelopment outcome after laser surgery for twin-twin transfusion syndrome (TTTS). The secondary objective was to identify perinatal prognostic factors associated with neurodevelopmental impairment. METHOD: This was a single-center cohort prospective study carried out in pregnancies complicated by TTTS and treated by laser. Neurodevleopmental assesment included the administration of Ages and Stages Questionnaires® (ASQ), for the infants between 2 and 5 years of age...
December 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27759174/estimated-combined-cardiac-output-and-laser-therapy-for-twin-twin-transfusion-syndrome
#16
Shiraz A Maskatia, Rodrigo Ruano, Alireza A Shamshirsaz, Pouya Javadian, Joshua A Kailin, Michael A Belfort, Carolyn A Altman, Nancy A Ayres
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) is the major cause for fetal demise in monochorionic diamniotic pregnancies. Estimated combined cardiac output (CCO) has not been studied in this setting. The primary aims of this study were to compare CCO in twin donor and recipient fetuses and assess differences in CCO before and after laser coagulation therapy. A secondary aim was to evaluate the relationship of CCO with perinatal mortality, defined as intrauterine or neonatal mortality (≤30 days of age) in fetuses that underwent laser coagulation therapy...
October 2016: Echocardiography
https://www.readbyqxmd.com/read/27751419/outcome-of-twin-twin-transfusion-syndrome-treated-by-laser-therapy-in-taiwan-s-single-center-role-of-quintero-staging-system
#17
Yao-Lung Chang, An-Shine Chao, Shuenn-Dyh Chang, Peter Cc Hsieh, Sheng-Yuan Su, Kuan-Ju Chen, Po-Jen Cheng, Tzu-Hao Wang
OBJECTIVE: To evaluate the outcome of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser therapy (FLT) stratified by Quintero staging. MATERIALS AND METHODS: A total of 100 TTTS cases treated by FLT, from October 2005 to August 2014, were included in this study. Cases were divided into first and second half periods to evaluate the learning effect-related outcomes, and logistic regression was applied to determine the independent factors in predicting the perinatal outcomes...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27686840/amniopatch-treatment-of-iatrogenic-preterm-premature-rupture-of-membranes-ipprom-after-fetoscopic-laser-surgery-for-twin-twin-transfusion-syndrome
#18
Ramen H Chmait, Eftichia V Kontopoulos, Andrew H Chon, Lisa M Korst, Arlyn Llanes, Rubén A Quintero
OBJECTIVES: Amniopatch is a proposed treatment of iatrogenic preterm premature rupture of membranes (iPPROM). We studied characteristics associated with successful amniopatch treatment of iPPROM after fetoscopic laser surgery for twin-twin transfusion syndrome. METHODS: Patients with iPPROM within 15 days of laser surgery treated with an amniopatch were studied. Factors associated with amniopatch success (i.e. cessation of leakage with normalization of amniotic fluid volume) were tested univariately and in multivariate logistic regression models...
August 10, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27597647/twin-anemia-polycythemia-sequence-a-single-center-experience-and-literature-review
#19
REVIEW
Amirhossein Moaddab, Ahmed A Nassr, Jimmy Espinoza, Rodrigo Ruano, Zhoobin H Bateni, Amir A Shamshirsaz, George T Mandy, Stephen E Welty, Hadi Erfani, Edwina J Popek, Michael A Belfort, Alireza A Shamshirsaz
Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27590373/a-prospective-pilot-study-of-fetoscopic-laser-surgery-for-twin-to-twin-transfusion-syndrome-between-26-and-27-weeks-of-gestation
#20
Masahiko Nakata, Keisuke Ishii, Masahiro Sumie, Mayumi Takano, Hiroko Hirata, Susumu Murata, Yuichiro Takahashi, Takeshi Murakoshi, Haruhiko Sago
OBJECTIVE: The aim of this study is to clarify the feasibility and efficacy of fetoscopic laser photocoagulation of placental vascular communicating vessels (FLP) on twin-twin transfusion syndrome (TTTS) after 26 weeks of gestation. MATERIALS AND METHODS: This is a prospective pilot study investigating all cases of TTTS between 26 weeks and 27 weeks during 2012 and 2013 in Japan. The primary endpoints in this study were the feasibility of FLP and rate of harmful complications for the mother's health...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
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