P09.19: Feasibility of fetoscopic laser surgery for twin amniotic fluid discordance

Abstract

Objectives: Twin to twin transfusion syndrome occurs In 15% of monochorionic twin pregnancies. Untreated, TTTS has traditionally been quoted to have a mortality of nearly 100%. The aim of the project was the investigation of the most optimal way of the diagnostic and therapeutic procedure in pregnancies complicated with TTTS and show antenatal and postnatal follow-up with at least 12 months of age. Methods: 64 pregnant women with twin to twin transfusion syndrome were assigned to laser therapy using diode laser. They underwent laser procedure at mean gestational age of 22 weeks of gestation at Quintero stages II–IV. Fetal echocardiography was performed before and after laser procedure; chosen parameters characterizing pregnancy were detailed described and analysed. Results: Survival rate of at least one twin was observed in 48 cases /48/64/ /considering at least 12 months follow-up/and it was equal to 75%. Neurological complications were observed in 4% /3/64/ in neonates at 6 months of age. Conclusions: Currently, preferred and the only method, which touches the cause of disease is endoscopic laser coagulation of anastomoses.