Outcome of twin-twin transfusion syndrome treated by laser therapy in Taiwan’s single center: Role of Quintero staging system

详细信息    查看全文

• 作者：Yao-Lung Chang ; ^{j12054@cgmh.org.tw" class="auth_mail" title="E-mail the corresponding author} ; An-Shine Chao ; Shuenn-Dyh Chang ; Peter CC. Hsieh ; Sheng-Yuan Su ; Kuan-Ju Chen ; Po-Jen Cheng ; Tzu-Hao Wang
• 关键词：fetoscope ; Quintero stage ; twin&ndash ; twin transfusion syndrome
• 刊名：Taiwanese Journal of Obstetrics and Gynecology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：55
• 期：5
• 页码：700-704
• 全文大小：325 K

文摘

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.

Results

The total fetal survival rate was 68.5%, two fetal survival rate was 55%, and at least one fetal survival rate was 82%. High Quintero stage (Stages III and IV) and small gestational age at delivery were two independent factors predicting lower two fetal survivals. Gestational age at delivery was the only independent factor predicting at least one survival. The odds ratios of high Quintero stage predicting lower two fetal survivals were 11.3 (p < 0.001) and 4.8 (p = 0.043) in the first and second periods, respectively.

Conclusion

High Quintero stage and small gestational age at delivery were associated with low two survival rate in TTTS treated by FLT; after gaining experience with FLT, the effect of high Quintero stage on lower two survival rate would decrease.