Resumen

Aim: To report the experience of intrauterine treatment of monochorionic biamniotic (MC/BA) twin pregnancies complicated with twin-to-twin transfusion syndrome (TTTS) with laser photocoagulation of placental vascular anastomoses (LPPVA). Material and methods: During an 18 months period 35 MC/BA twin pregnancies were treated. TTTS was diagnosed based on the discrepancies in amniotic fluid and bladder size between both twins. Severity of TTTS was classified according to hemodynamic parameters in both twins. LPPVA was performed between 16-26 weeks of gestation using a rigid straight fetoscope and YAG (neodymium: yttrium aluminum garnet) laser equipment. Survival was considered when the neonate was home discharged. Results: Overall survival was 62.8% (44/70 fetuses). In 77% of pregnancies (27/35) at least one twin survived, and in 48.5% (17/35) of cases both twins survived. Bleeding was the most frequent complication (12/35; 34%). In 5 cases there was severe bleeding leading to premature rupture of membranes and death of both twins. Average time stay in the neonatal intensive care unit was 20 days (range, 7-120). There were no signs of brain damage at the time of discharge. Conclusion: These results are similar to those alredy published in the literature. Bleeding was the most frequent complication, however when the team experience improved this condition was observed less frequently. Overall success is highly associated with a good neonatal care support.

Palabras clave: Monochorionic twin pregnancy. Twin to twin transfusion syndrome. Laser photocoagulation.

2013-07-24   |   496 visitas   |   Evalua este artículo 0 valoraciones

Vol. 63 Núm.1. Enero-Enero 2011 Pags. 46-52 Rev Invest Clin 2011; 63(1-ENGLISH)