Fetal Diagnosis and Therapy最新文献

{"title":"Safety and Effectiveness of Fetal Myelomeningocele Repair: Case Series Analysis Using an Exteriorized Uterus and a Fetoscopic Approach.","authors":"Márcio Lopes Miranda, Renato Ximenes, Kleber Cursino Andrade, Carlos Baldo, Mauro Villarreal, Marcos Roberto Caetano, Giuliane Lajos, Mateus Dal Fabbro, Joaquim Murray Bustorff-Silva, Emrah Aydin, Jose L Peiro","doi":"10.1159/000546549","DOIUrl":"10.1159/000546549","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the surgical details and outcomes of fetal myelomeningocele (MMC) repair using a minimally invasive fetoscopic approach with uterine exposure.</p><p><strong>Methods: </strong>This retrospective case series study examines consecutive fetuses who underwent fetoscopic spina bifida repair performed by a single team. The pregnant women's demographic data, surgical technical aspects, complications, and neonatal surgical outcomes were analyzed.</p><p><strong>Results: </strong>From 2019 to 2022, 32 fetuses underwent the fetoscopic repair of MMC at an average gestational age of 25.2 ± 0.9 weeks (range 23.2-26.6). Dura mater collagen substitutes were used for duraplasty in all cases, and in three, an additional myofascial flap was used. There were no significant maternal complications. Overall perinatal complication rate was 18% (6/32), including a perinatal mortality rate of 12.5% (4/32) and two cases of skin suture dehiscence. No cases of cerebrospinal fluid (CSF) leakage were observed. The mean gestational age at birth was 34.6 ± 3.6 weeks, and 31% of deliveries were vaginal. Among the 28 neonates followed for at least 12 months, and only 14% required CSF diversion.</p><p><strong>Conclusion: </strong>Exteriorized uterus fetoscopic repair of MMC proved safe for the mother and effective in closing the neural tube defect. It also reduced the necessity for CSF diversion and preserved uterine function for future pregnancies. These findings endorse the potential of minimally invasive techniques in fetal MMC repair.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal Advanced Neurosonography in the First Trimester of Pregnancy.","authors":"Mª Angeles Rodríguez, Mónica Echevarría, Laura Perdomo, Ignacio Rodríguez, Gerard Albaiges, Miriam Illa, Pilar Prats","doi":"10.1159/000546460","DOIUrl":"10.1159/000546460","url":null,"abstract":"<p><strong>Introduction: </strong>Some of the central nervous system malformations (CNSs) can be detected or suspected during the first trimester.</p><p><strong>Methods: </strong>Prospective observational study including singleton pregnancies, CRL between 60 and 82 mm and normal basic ultrasound examination. In the axial plane, we examined: lateral ventricles (LV), choroid plexus of LV (PCVL), PCVL/VL ratio, insula, cerebellum, distance from Sylvian aqueduct to occipital bone, IV ventricle (IVV), and cisterna magna (CM) and in the sagittal plane, we assessed: 4 lines-3 spaces, brain stem (BS), fourth ventricle, IVV choroid plexus (PC), CM, distance from BS to occipital bone (BSOB) and BS/BSOB ratio.</p><p><strong>Results: </strong>Ninety-two fetuses were included. The extended examination was successfully performed in 86 (93.5%) cases. The insula, LV and CPLV (axial planes) as well as all structures in the sagittal planes were assessed at 100%. The IVV, PC and CM (axial planes) were visualized at 90 (97.8%) fetuses. In 89 (96.7%) fetuses, the cerebellum was successfully evaluated, while in 88 (95.7%) cases, the tectum, aqueduct of Sylvius, and Ac-Oc distance were measured. Good intra- and interobserver concordance was observed for all parameters, as confirmed by Bland-Altman analyses. Advanced ultrasound increased the total examination time by 3 min compared to basic examination.</p><p><strong>Conclusions: </strong>Advanced first-trimester CNS assessment, including the incorporation of early markers to predict CNS abnormalities, is feasible with good intra- and interobserver agreement and minimal additional ultrasound scanning time.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saccular Limited Dorsal Myeloschisis: A Distinct Prenatal Entity.","authors":"G Ponmozhi, K Manikandan","doi":"10.1159/000546325","DOIUrl":"10.1159/000546325","url":null,"abstract":"<p><strong>Introduction: </strong>LDM is a distinct form of spinal dysraphism characterized by two important features: a focal \"closed\" midline defect and a fibroneural stalk that connects the skin lesion to the underlying cord. When a fluid-filled sac overlies the defect, it is classified as saccular LDM (s-LDM). The embryogenesis is incomplete disjunction between cutaneous and neural ectoderms - allowing persistence of a physical connection between the disjunction site and the dorsal neural tube. We aim to describe the prenatal features and perinatal outcomes of s-LDM.</p><p><strong>Methods: </strong>This study is a review of case records from January 2018 to April 2024. A lesion was classified as s-LDM if the following criteria were met: (a) fluid-filled saccular lesion in the midline of the fetal back overlying dysraphic spine; (b) echogenic stalk connecting the saccular lesion to the cord. Presence or absence of posterior fossa abnormalities (Chiari II malformation) was not required for the diagnosis or exclusion.</p><p><strong>Results: </strong>Twenty-three cases of LDM were identified - 5 cervical, 3 lumbosacral, 1 lumbar, and 14 sacral. A fibroneural stalk was identified in all. Perinatal outcome was available in all but one. Ten patients (1 cervical, 3 lumbosacral, 6 sacral) underwent surgery after birth, two awaiting surgery at the time of writing this paper. Ten pregnancies underwent termination, and one was lost to follow-up. Additional prenatal findings included obliteration of cisterna magna in two fetuses, frontal bone scalloping in three, bilateral ventriculomegaly in two, underlying intraspinal lipoma in one, Blake pouch cyst in two, and low-placed conus in twenty fetuses. Head circumference was normal in all cases.</p><p><strong>Conclusion: </strong>s-LDM has unique sonographic features making it feasible for a definitive prenatal diagnosis. This is important since the postnatal surgical outcome is vastly different from myelomeningocele.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Testing for Cystic Fibrosis in the Central Denmark Region (2012-2023).","authors":"Line Dahl Jeppesen, Stine Skibsted Rinder, Naja Becher, Lotte Andreasen, Puk Sandager, Ida Vogel","doi":"10.1159/000546547","DOIUrl":"10.1159/000546547","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic fibrosis (CF) is a severe genetic disorder with a carrier frequency of 1 in 30. In Denmark, prenatal testing is offered when there is a family history of CF or ultrasound anomalies suggest an increased risk of the disease. This study evaluates indications for prenatal CF testing and their outcomes.</p><p><strong>Methods: </strong>Clinical indications and genetic results were analyzed for pregnancies undergoing CF testing in the Central Denmark Region between August 2012 and 2023. The data were categorized according to clinical indication.</p><p><strong>Results: </strong>Among 302 prenatal CF tests, echogenic bowel (EB) was the most frequent (44.7%, N = 135), leading to identification of one CF-affected fetus (0.7%). The second most common indication was EB together with non-CF-associated ultrasound findings (29.5%, N = 89), with no CF-affected fetuses. Known CF predisposition due to family history (15.6%, N = 47) identified five affected fetuses (10.6%) and 25 carriers (53.2%). No CF cases were detected in other included groups (N = 31).</p><p><strong>Conclusion: </strong>These data show that EB has a low positive predictive value for cystic fibrosis in the fetus (1:230) in a country with combined first-trimester screening but no systematic preconception or prenatal screening program for cystic fibrosis. Although the relative risk is increased compared to the general population (1:2,500), EB appears to be a marker of limited clinical utility. In settings without dedicated CF screening strategies, this underscores the importance of considering the most effective allocation of diagnostic resources.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential Amnioinfusion Protocol for Treating Fetal Renal Failure: Impact on Survival and Transition to Renal Transplantation.","authors":"Kevin Magee, Kristen Lee Moriarty, Grant Delanoy, Paxton Alexander, Albert Quan, Ella Meyer, Clair Schwendeman, Erica Hammer, Elizabeth A Morgan, Timothy M Crombleholme","doi":"10.1159/000546454","DOIUrl":"10.1159/000546454","url":null,"abstract":"<p><strong>Introduction: </strong>Fetal renal failure (FRF) is a challenging antenatal diagnosis associated with insufficient pulmonary development and potential compromise for the future possibility of dialysis and kidney transplantation. Even in cases in which lung development can be fostered by serial amnioinfusions (AIs), infants who are born prematurely may not qualify for peritoneal dialysis due to weight criteria.</p><p><strong>Methods: </strong>We describe our outcomes after introducing an integrated approach at two institutions to prenatal management of FRF with a serial AI protocol and postnatal management with peritoneal dialysis. Our primary endpoint was survival to 6 months of age with successful dialysis, and the secondary outcomes included the ability to transition to renal transplantation.</p><p><strong>Results: </strong>The mean gestational age at which AIs were initiated was 23.3 ± 2.32 weeks for the whole cohort. There was no significant difference between survivors (22.51 ± 1.70 weeks) and non-survivors (23.31 ± 2.69 weeks, p = 0.339) in the gestational age at initiation of AIs. The mean gestational age at delivery for the entire cohort was 34.8 ± 2.62 weeks, and there was a trend toward but did not achieve significance between survivors (35.0 ± 1.60 weeks) compared to non-survivors (33.17 ± 3.34 weeks, p = 0.066). Survival to delivery was 100% for the total AI cohort (n = 30).</p><p><strong>Conclusion: </strong>A total of 83% of patients alive at 48 h survived the neonatal period and of those surviving the neonatal period, 62.5% survived a minimum of 6 months on outpatient peritoneal dialysis (PD). This series also established that PD can be successfully performed in neonates as small as 1,500 g. Four patients have successfully undergone renal transplantation. Serial AIs for FRF offer the potential, not only in neonatal pulmonary survival but also long-term survival to kidney transplantation.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Operative Predictors of Survival in Twin-Twin Transfusion Syndrome Undergoing Fetoscopic Laser Treatment.","authors":"Henry L Galan, Michael V Zaretsky, Zhaoxing Pan, Nicholas Behrendt, S Christopher Derderian, Stephen Paul Emery, Anthony Johnson, Greg Ryan, William H Goodnight","doi":"10.1159/000546365","DOIUrl":"10.1159/000546365","url":null,"abstract":"<p><strong>Introduction: </strong>Limited data exist regarding the effect of pre-operative risk factors on fetal survival for patients undergoing fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). The primary objective of this study was to determine the pre-operative variables predictive of single and dual fetal survival at birth for subjects treated with laser for TTTS. The secondary objective was to determine the combined effect of multiple risk factors on single and dual fetal survival at birth.</p><p><strong>Methods: </strong>This was a prospective cohort study of TTTS pregnancies treated with FLP between 2001 and 2023. Cases were identified through the Monochorionic Twin Pregnancy Registry of the North American Fetal Therapy Network. Several pre-operative risk factors were evaluated, including maternal body mass index, gestational age at laser, fetal growth restriction (FGR), cervical length, placental location, and TTTS stage. Higher order multiples, fetal anomalies, karyotypic abnormalities, and cases with missing data were excluded. Risk factors influencing survival were assessed with uni- and multi-variate regression analyses. The predicted probability of single/dual survival based on these risk factors was assessed with multiple logistic regression analysis.</p><p><strong>Results: </strong>Of 2,728 FLP cases, 1,066 met inclusion criteria. Dual survival is reduced in stage 3 and 4 disease compared to stage 1 and 2 (OR 0.75: 0.58, 0.98; p = 0.032) with the lowest survival in all stages occurring with FGR. An anterior placenta (aOR 0.58: 0.37, 0.91; p = 0.017) and FGR <10th percentile (aOR 0.57: 0.35, 0.92; p = 0.02) were independent predictors of reduced survival. With regression modeling, sequential addition of any pre-operative risk factor progressively reduces survival of at least one or both twins.</p><p><strong>Conclusions: </strong>In this large registry, anterior placental location and FGR were most predictive of reduced survival for both twins. As the number of pre-operative risk factors increases for a given TTTS case, there is a progressive reduction in survival probability and these reported probability rates may be useful in counseling patients.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Diagnosis and Management of Fetal Anemia Caused by Compound Heterozygous Hemoglobin Q-Thailand and Hemoglobin Constant Spring.","authors":"Suchaya Luewan, Srimeunwai Ake-Sittipaisarn, Pimlak Charoenkwan, Theera Tongsong","doi":"10.1159/000546277","DOIUrl":"10.1159/000546277","url":null,"abstract":"<p><strong>Introduction: </strong>Compound heterozygous hemoglobin Q-Thailand (Hb QT) and hemoglobin Constant Spring (Hb CS) are rare hemoglobinopathies found occasionally in Southeast Asia. This condition is associated with varying degrees of anemia. This report aims to describe the prenatal diagnosis, natural course, and intrauterine treatment of Hb QT/CS disease, which is thought to be more severe during fetal development than to later in life.</p><p><strong>Case presentation: </strong>A 23-year-old pregnant woman who was at risk of fetal Hb E/β-thalassemia underwent a prenatal ultrasound examination and cordocentesis at 21 weeks of gestation. The ultrasound revealed signs of fetal anemia, including mild cardiomegaly and normal peak systolic velocity in the middle cerebral artery (MCA-PSV). Fetal hemoglobin analysis revealed a diagnosis of Hb QT/CS disease, which was confirmed by molecular study. A follow-up ultrasound at 23 weeks showed progressive cardiac enlargement, increased anemia, increased MCA-PSV, and mild hydropic changes. An intrauterine blood transfusion (IUT) was administered. Subsequent ultrasounds demonstrated a complete resolution of the hydropic signs. The fetus required only one IUT, and the anemia improved spontaneously later in the pregnancy. The woman delivered a healthy male newborn vaginally at 39 weeks of gestation.</p><p><strong>Conclusion: </strong>Hb QT/CS disease can lead to fetal anemia and hydrops fetalis. However, the severity of anemia in this case improves as the pregnancy progresses toward term. If the fetus survives the critical period in utero without significant organ damage from anemia, a favorable long-term prognosis is possible. This report is the first to describe the prenatal diagnosis, natural course, and intrauterine treatment of Hb QT/CS disease with a successful outcome.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of intrauterine infectious and inflammatory complications in the development of necrotizing enterocolitis in a newborn from preterm prelabor rupture of membranes gestation: a retrospective cohort study.","authors":"Jana Leskova, Marian Kacerovsky, Julie Ledvinova, Anna Parmar, Helena Hornychova, Radek Stichhauer, Jan Maly, Ivana Musilova","doi":"10.1159/000546257","DOIUrl":"https://doi.org/10.1159/000546257","url":null,"abstract":"<p><p>Introduction This study aimed to evaluate whether the presence of microbial invasion of the amniotic cavity (MIAC) and/or acute histological chorioamnionitis (HCA), as well as their subtypes, in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) is related to the subsequent development of necrotizing enterocolitis (NEC) in newborns from these pregnancies. Methods This retrospective study included 295 women with singleton pregnancies complicated by PPROM between gestational ages 24+0 and 31+6 weeks who underwent transabdominal amniocentesis. MIAC was detected using a combination of cultivated and non-cultivated methods. HCA was revealed by histopathological examination of the placenta. Only neonates with stage IIa of the modified Bell's criteria were considered to have NEC. Results NEC developed in 3% (10/295) of newborns. There were no differences in the rates of MIAC (p=0.33), HCA with the absence (p=1.00) or presence of fetal inflammatory response (p=0.52), and HCA with acute inflammation of the amnion (p=0.20) between those who developed and did not develop NEC. Conclusion Neither MIAC nor HCA was associated with the development of NEC in newborns from singleton pregnancies complicated by PPROM between 24+0 and 31+6 weeks of gestation.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-27"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction of Fetal Hydrocephalus Followed by Ventriculoamniotic Shunting and End of Study Analysis in the Pregnant Sheep Model.","authors":"Stephen Paul Emery, Stephanie Greene, Nika Marie Hazen, Youngjae Chun","doi":"10.1159/000546161","DOIUrl":"10.1159/000546161","url":null,"abstract":"<p><strong>Introduction: </strong>As part of an evidence-based reassessment of ventriculoamniotic shunting for fetal aqueductal stenosis, we developed an animal model for the induction of hydrocephalus, placement of a ventriculoamniotic shunt, and end of study analysis in fetal sheep.</p><p><strong>Methods: </strong>We made multiple revisions to both the animal model and the shunt over time. Regarding the animal model, we found that induction of hydrocephalus at 85 days gestation, shunt placement at 100 days gestation, and study end at 135 days gestation generated the most reproducible results.</p><p><strong>Conclusion: </strong>The purpose of this manuscript was to document step-by-step instructions for hydrocephalus induction, shunt placement, and end of study analysis so that those who wish to develop a fetal hydrocephalus model, repeat our experience with ventriculoamniotic shunting, or test other interventions may benefit from our experience. Moreover, standardization of methodology will allow for meaningful comparisons between investigators.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaboration on Treatment of Twin-to-Twin Transfusion Syndrome in a Borderless Nordic Center.","authors":"Lone Nikoline Nørgaard, Maria Stefopoulou, Lotte Harmsen, Birgitte Kahrs, Peter Lindgren, Georg Macharey, Vedran Stefanovic, Laura Seikku, Karin Sundberg, Ayden Tekay, Eleonor Tiblad","doi":"10.1159/000546127","DOIUrl":"10.1159/000546127","url":null,"abstract":"<p><strong>Introduction: </strong>The Nordic Fetal Therapy Alliance centralizes treatment of twin-to-twin transfusion (TTTS) to ensure high-quality fetal therapy. This study reports the outcomes of treated TTTS cases and highlights the importance of international collaboration.</p><p><strong>Methods: </strong>We conducted a prospective observational study on all pregnancies undergoing TTTS surgery between May 2019 and April 2022 in the Nordic countries. The primary outcome was perinatal survival at 28 days. Secondary outcomes were gestational age (GA) at delivery, procedure-related complications, and mode of delivery.</p><p><strong>Results: </strong>A total of 200 cases underwent fetal surgery; 185 were treated with fetoscopic laser photocoagulation (FLP), and 15 with primary selective reduction by cord occlusion (CO). FLP resulted in at least one surviving neonate in 86% and in at least two survivors in 64%. Median GA at surgery was 20+1 weeks (range 15+1; 29+0), and median GA at delivery was 32+2 weeks (range 24+3; 41+0). In the CO group, 80% had at least one surviving neonate. Preterm premature rupture of membranes occurred in 13.6% within the FLP group and none in the CO group. Post-laser twin-anemia polycythemia sequence occurred in 5.4%.</p><p><strong>Conclusion: </strong>Collaboration across borders on TTTS treatment in the Nordic region is possible, and outcome results are comparable to other International Centers.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}