Predictive Indicators and Outcomes of Pregnancies Affected by Stage I Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI:10.1002/pd.6691

Maiko Wagata, Seiji Wada, Haruhiko Sago, Makiko Shimabukuro, Masahiko Nakata, Shigenori Iwagaki, Yuichiro Takahashi, Hiroko Konno, Takeshi Murakoshi, Keisuke Ishii

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引用次数: 0

Abstract

Objective: The significance of fetoscopic laser photocoagulation (FLP) in stage I twin-twin transfusion syndrome (TTTS) remains controversial. This study aimed to clarify the outcomes and prognostic factors of stage I TTTS after FLP.

Method: We conducted a retrospective cohort study on patients with stage I TTTS who underwent FLP in Japan. The primary outcome was neonatal survival at 28 days. The adjusted odds ratios (aOR) of pre- and intraoperative factors for mortality in recipient and donor twins were calculated.

Results: This study included 272 twin pairs. The survival rate of at least one twin and both twins was 98% (267 pairs) and 85% (232 pairs), respectively. Survival of the recipient twin was observed in 253 cases (93%). No factor was associated with the mortality of the recipients. Among the donor twins, 246 (90%) survived. Preoperative twin anemia-polycythemia sequence (aOR, 17.45; 95% CI, 3.16-96.31) and arterio-arterial vascular anastomosis (AAA) identified at FLP (aOR, 2.78; 95% CI, 1.10-7.06) were independently associated with mortality of the donors.

Conclusion: The neonatal survival rate for both recipient and donor twins was > 90% among patients with stage I TTTS who underwent FLP. AAA is a risk factor for mortality in donors following FLP, though the pathophysiology of AAA remains to be clarified.

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采用胎腔镜激光光凝术治疗受 I 期双胎输血综合征影响的孕妇的预测指标和预后。

目的：胎儿镜激光光凝术（FLP）对 I 期双胎输血综合征（TTTS）的意义仍存在争议。本研究旨在明确 I 期 TTTS 在接受 FLP 后的结果和预后因素：我们对日本接受FLP的I期TTTS患者进行了一项回顾性队列研究。主要结果是新生儿 28 天的存活率。计算了受体和供体双胎术前和术中死亡因素的调整几率比（aOR）：结果：这项研究包括 272 对双胞胎。至少一对双胞胎和两对双胞胎的存活率分别为 98%（267 对）和 85%（232 对）。受体双胞胎的存活率为 253 例（93%）。没有任何因素与受体的死亡率有关。供体双胞胎中有 246 例（90%）存活。术前双胞胎贫血-多红细胞序列（aOR，17.45；95% CI，3.16-96.31）和FLP时发现的动脉-动脉血管吻合术（AAA）（aOR，2.78；95% CI，1.10-7.06）与供体的死亡率独立相关：结论：在接受FLP的I期TTTS患者中，受体和供体双胞胎的新生儿存活率均大于90%。AAA是FLP术后供体死亡的一个风险因素，但AAA的病理生理学仍有待明确。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling